Marketisation without limits.
That, effectively, is the message of health secretary Patricia Hewitt (see Alex Nunns). Here speaks a government that is absolutely convinced that there is no alternative to the market model of delivering public services. A model in which the state becomes the contractor and, more or less half-heartedly, the regulator. What underlies this zeal?
I once heard Jack Straw answer a warm up question on Any Questions: ‘What was your vision of the good society in 1968?’ Without a moment’s hesitation, he answered:’The command economy plus parliamentary democracy.’ Now, presumably, the answer would be: ‘The global market plus parliamentary democracy’ – said with equal certainty.
It is as much a fantasy formula as Straw’s student vision. And the reality of private corporations beyond the reach of elected politicians is as much on a slow fuse to disaster as the impermeably authoritarian states of the Soviet bloc.
The corporate juggernauts are being met with resistance as they drive through our public services. In August, a local campaign in Langwith, Derbyshire, won its appeal against the US United Health corporation taking over the local GP practice. But such opposition is dispersed and without a coherent alternative.
‘There’s no doubt we need to develop our own design for the NHS without the market,’ says Langwith GP, Dr Elizabeth Barrett, ‘but I’m only just beginning to think about it.’ The problem is less one of organisational unity on the left than of the need for a powerful, shared sense of direction that can resonate with the disaffection that is far more widespread than the committed left alone.To generate a sufficiently ambitious vision we need at the same time to be more realistic and more imaginative, simultaneously more attentive to the creativity implicit in local struggles and more willing to learn from international experiences.
We have to face the fact that an immensely powerful process of destruction and reconfiguration of economic, state and cultural institutions is going on; and unless we are able to assert an alternative dynamic, its outcome will be determined by the United Healths of this world.We also have to recognise that under existing forms of democracy – Jack Straw’s parliamentary democracy – our political institutions are too conservative to offer a sufficiently innovative means of developing an alternative.
Social democratic state institutions have long been difficult to get to move.
The rare exceptions, like Ken Livingstone’s GLC in the 1980s, prove the rule.The inbuilt cautiousness is only overcome through stimulating the pressure from social movements and radical civil society – funding the third sector not just to implement policies but also to bite the hand that feeds it and keep the politicians to their initial radical electoral mandate (an interesting contrast with the shackles that government now puts on its funding of this sector – see Martin McIvor,).
The new fluidity of state institutions – initially a destructive process – is producing, mainly in the course of resistance, ad hoc attempts to design a deeper democracy. Dr Barratt points to the ways she is working with patients and staff in opposition to the government’s market model to open up the management of the local primary care service. On North Tyneside, trade unionists are resisting the wholesale privatisation of services, all the time pushing for openness and trade union and user involvement in the procurement and bidding processes to secure a public sector option. In effect, they are trying to subvert marketisation by way of a wedge of democratic control over public delivery.
Jack Straw’s youthful scenario exposes the problem with the past methodology of a large part of the communist and Labour left. This is the focus on structures – property, state institutions and so on – ignoring other levels of social reality, including interactions between people, the complexity of the individual as a social being – emotions, personality, psychology – and relations with nature.
Jonathan Rutherford\’s article considers the work of the think-tank Compass on approaches that take these other levels of social reality seriously. But as he points out, any ‘new’ politics of the left must avoid the opposite mistake to that made in the past by not focusing on issues of individual personality, interactions between people and relations with nature without at the same time challenging the structural conditions – such as material inequality, unaccountable centres of economic and military power and the rampant, unregulated market – that block the possibilities of emancipatory social relations, environmental justice and individual fulfillment.
The challenge here is to develop institutional structures that are open to fluidity and innovation. Command bureaucracies don’t do this. But rather than seeking the solution through markets or private monopolies, the need is to find ways for the state and its services to reinvent themselves in response to multiple social needs, social and economic struggles and the emergence of new kinds of social relationship.
There is no simple formula for this. We need to build time into our political activity for investigation and reflection, including using the web to generate new tools for creative collaboration. Maybe we should develop ‘OurSpace’ to brainstorm, exchange ideas and learn from the countless thousands of practical experiments that are redesigning social relations and making demands for new structures to sustain them.