Catastrophe

So post-truth politics won the day and in a grotesque act of national self-harm Britain has voted to leave the EU. Within hours reality began to bite back as the warnings of the much-derided experts started to become true. Stock markets around the world were in free fall, the pound crashed through the floor, and companies began to announce plans to move jobs and investment out. All through the campaign leavers braggingly talked of how Britain is the world’s fifth largest economy. Not any more it isn’t. Within just a day it has become the sixth largest. Again as warned, Scotland made the first moves towards what will undoubtedly be independence, and Northern Ireland might well follow or in any case faces turmoil. Calls to shift the British border back from Calais began. The Prime Minister resigned but not with immediate effect and so a complete political paralysis now exists, and there are rumours that senior civil servants are likely to resign en masse because they know that what they are going to be expected to deliver is completely impractical. This is just day one of what will be years of uncertainty and chaos.

Reality bit in other ways, too. Before the sun had set leading Brexiters disowned the claims that there would be £350M a week more spent on the NHS, and that there would be reductions in immigration. So that was two of the three central planks of their campaign discarded. And what of the third, ‘taking back control’? As had again been said all along, it immediately emerged that the Brexiters have not a single idea about what it is that is now going to happen, when, or how. Having with anarchistic, reckless glee booted down the central pillars of decades of foreign and economic policy they had literally nothing – nothing - to say other than that a ‘glorious future’ beckoned. Suddenly, having won their prize they do not even want to begin the process of leaving and seem amazed and outraged that the rest of the EU is saying that they need to do so. Out is out.

There are no good outcomes for England now. The best that can be hoped for might be some kind of Norwegian-style arrangement, although it is by no means clear that this will be available. Even if it were it would be very tricky, politically, although there would be a parliamentary majority for it, because it would mean free movement of people. But as the effects of Brexit get clearer, and the lies of the leave campaign are exposed, there are already signs that some who voted to leave are regretting it (‘Regrexit’ is the word du jour) and if opinion polls bore that out in large numbers it’s just about conceivable that such an arrangement could be agreed without a further referendum. It would just about honour the letter of the vote to leave the EU and frankly since the leavers refused to spell out what leave meant they would just have to accept that. But it would lead to decades of claims of ‘betrayal’ and ‘we did not know what we voted for’.

Whatever happens, the economic consequences are going to be dire for years to come. Anyone thinking that it represents a triumph of working-class solidarity over global neo-liberalism is in for a very nasty shock indeed when jobs start to haemorrhage and public finances and services collapse. A very chilling lesson in reality is about to administered and although it won’t only be those who voted leave who suffer it is likely to impact them the worst.  But the real catastrophe is a cultural one. It is a massive defeat for Britain as a place of tolerance, cosmopolitanism and openness; a victory for every sort of prejudice, for sullen and bitter anti-intellectualism, for resentful small-mindedness. Huge rifts between classes, generations and regions have been opened and they aren’t going to be healed any time soon. My European friends living here are shocked and scared, whilst friends abroad look on in bemusement and horror at what has happened.

As for me, I feel distraught and physically sick. As the Brexiters crow of having ‘got their country back’, I feel that I have lost my home and now live in exile.

The sleep of reason

The expression ‘post-truth politics’ is one which I have only just become aware of, and I am not sure who coined it. The earliest usage I have found is an article about the 2012 US presidential election (Parmar, 2012) but it seems to already have been a term in use at that time.

It has come to the fore in the UK now as people begin to reflect upon the EU Referendum. Since the vote is being held today I don’t know what the outcome will be but the polls suggest the result will be close. Much of the campaign has employed familiar techniques of political rhetoric which inevitably include partial facts, selective interpretations, spinning and sloganizing of all sorts. But it has also seen repeated lies told, especially those which I have written about before concerning the size of the UK budget contribution to the EU and the assertion that Turkey is joining the EU.

It is not that telling lies in politics is new, and it isn’t that which in itself constitutes post-truth politics. It is the sense that the truth does not even matter, or that there is not even a truth to be told and, therefore, that it is meaningless to speak of lies being told. The political roots of that in the UK are associated in my mind, at least, with the way that the case was made for the Iraq War in 2003 and, more generally, with the newly relentless emphasis on ‘news management’ by the New Labour governments.

There was nothing new about spin either, of course, but this was something different. In particular, one of Tony Blair’s distinctive skills when in difficulty was to ‘break through the fourth wall’. This expression, derived from the theatre, refers to an actor speaking directly to the audience and in the process revealing the artifice of the stage. It’s just a play, after all – which we already know, but suspend our knowledge of until that knowledge is shattered. In politics this has the effect of simultaneously acknowledging but re-enforcing the idea that it is all just a game.

For skilled politicians like Blair this is a strangely disarming way of having the cake of playing the game whilst eating the cake of ironized authenticity. The blustering humour of politicians like Donald Trump or, in the Referendum context, Boris Johnson when ‘caught out’ in some particularly preposterous claim is somewhat similar. It draws the audience into a knowing acknowledgment of artifice, whilst inviting applause for the actor’s ‘honesty’ in exposing it. It’s this, rather than the telling of lies as such, which defines post-truth (and therefore post-lie) politics.

The intellectual roots of post-truth may lie with a (bowdlerized) version of post-modernism or of social constructionism: there is no truth, only interpretations. Something like this is apparent in the way that the campaign has been covered by the BBC, in particular, where a commitment to ‘balance’ has meant that every claim by one side has always been accompanied by a report of a counter-claim from the other. Again there is no truth, just opposing representations of truth; thus for every five minutes airtime saying that Turkey is not joining the EU there must be five minutes of airtime saying the opposite. Never mind that Turkey is not, as a matter of fact, joining the EU. I had a conversation at the weekend with someone about the EU debate and she suggested that whatever the facts about – in this particular conversation – immigration these didn’t matter for those concerned about it since what they claimed to be the facts were ‘true for them’ and that was what mattered.

If that is so then we have to give up on any sense of rationality in political discourse, and indeed the campaign can be read as a kind of battle between rational and post-truth politics. Thus the remain campaign deployed endless statements from various experts in economics, trade, security and so on. In response, leading leave campaigner Michael Gove opined that “the people of this country have had enough of experts”. Incredibly, he subsequently compared pro-Brexit experts to the Nazis using scientific experts to denounce Einstein’s theories as wrong, in support of anti-semitic ideology. This from a former Education Minister!

Although usually less colourfully expressed, this trope of experts being in some way corrupt or untrustworthy has run through the leave campaign. It fits very neatly – like the rest of the leave campaign – with a populism in which ‘ordinary folk’ or consistently done down by ‘the elite’ – often, the ‘liberal elite’. The logic is completely circular – the evidence that they are the elite is that they disagree; the reason they disagree is that they are the elite. In this hermetically-sealed world anyone from global corporations to trade union leaders to ‘faceless bureaucrats’ to ‘the politically correct brigade’ to ‘so-called intellectuals’ are all part of an orchestrated conspiracy. Unless, of course, someone from one of these groups comes out in favour of the populist cause, at which point they become the fount of all wisdom, ‘courageously’ speaking out.

There is an interesting and important overlap between post-truth politics and the cosmopolitan and local split which I have talked about elsewhere. For the polling evidence suggests that views on EU membership are very clearly socially stratified: the more educated people are, the more likely they are to favour EU membership; the higher their social class (which is linked to educational level) the more likely they are to favour EU membership. As with Trump’s appeal, the cleavage is between those who gain from, or at least can cope with, globalization and those who suffer from its effects. In this way, post-truth politics are inextricably linked with the consequences of neo-liberalization. And in a way there is a connection between postmodern relativism and neo-liberalism: in the marketplace of ideas you pick the one that best expresses your economic interests.

These things probably connect with the media and social media culture in which ‘passion’ is the dominant value. Thus every game show contestant is judged on how passionately they want to win, just as post-truth politicians assure us of how passionate they are about their cause. What matters most is how strongly you feel. In that calculus, it is irrelevant whether what you feel is justified by evidence or argument; the strength of the feeling is its own validation. And why not? If, as my friend told me in the conversation I mentioned earlier, what matters is what people think is true then between all the different things that people think are true the only way to adjudicate between competing beliefs is the strength with which they are held.

But there are huge dangers here. The Spanish artist Francisco Goya captioned the most famous of his Los Caprichos etchings thus: “the sleep of reason brings forth monsters” (El sueño de la razón produce monstruos). This inspired the title of The Sleep of Reason (1968) a novel by C. P. Snow about whom I have written elsewhere on this blog. It is a reminder of the dangers of the abandonment of rationality, which are just as great as those of an over-attachment to rationality – dangers which include technocracy and totalitarianism. Tomorrow we will learn whether post-truth politics have won the EU Referendum but, even if it has not, its appeal and its consequences will not disappear.

 

References

Parmar, I. (2012). ‘US Presidential Election 2012: Post-truth Politics’, Political Insight 3 (2): 4-7
Snow, C.P. (1968). The Sleep of Reason. London: Macmillan.

Rotten business

I’ve written previously about the collapse of retailer BHS. This week, some of the grisly details began to emerge, as a parliamentary select committee began its investigations. Particularly striking was evidence given by former executives about its owner Dominic Chappell. Chappell – a thrice bankrupt former racing driver with no retail experience – bought BHS for £1 in in 2015. In the hearing, former finance consultant to BHS Michael Hitchcock called Chappell a Premier League class liar with his fingers in the till whilst Darren Topp, the former CEO, claimed that Chappell threatened to kill him.

Next week, Sir Philip Green, who, having ransacked the business, sold it to Chappell is also due to appear before parliament to answer questions about what happened to the pension fund. He is facing pressure to make good the fund’s £571M deficit and there are calls for him to be stripped of his knighthood.

BHS is now being wound down, with its 11,000 employees facing redundancy, because no buyer could be found. Yet, according to Chappell, there was a willing buyer who was dissuaded from the purchase by Green (something Green denies). This buyer was Mike Ashley, who is now to be called to give evidence about this.

By a strange coincidence, Ashley – founder and owner of retailer Sports Direct – also appeared before a parliamentary committee this week (despite attempts to avoid doing so). Sports Direct stands accused of failing to pay staff the minimum wage, and a litany of unpleasant practices with the effect that:

“There had been 110 ambulance call-outs to his main warehouse site in just over three years as workers suffered chest pains, stroke, injury, and five births or miscarriages – including one woman delivering her baby in the toilet – such was the fear, according to the union, of losing your job if you took time off … [with] allegations made that the time staff spent queuing to be partly strip-searched by security guards before leaving the factory had driven wages below the legal national minimum wage per hour, or that female workers were sometimes asked for sexual favours in return for longer hours.”

I suppose there is some comfort to be drawn from the fact that these cases are being investigated by parliament, and the increased power and activism of select committees is, I think, a positive development. And, of course, there are plenty of good and responsible employers.

Yet these two stories taken together seem to disclose something about the dire state of management practices in some and perhaps many parts of British businesses today, and about the, let’s say, unappealing characters who lead those businesses. And it’s not just in Britain. Last month Oxfam reported that chicken farm workers in the US were being denied toilet breaks and forced to wear nappies. This won’t come as a surprise to readers of my book, where (p.133) I give the example of a Californian factory in which workers were told to urinate in their clothes rather than take toilet breaks. Indeed, the poultry workers are rather humanely treated by comparison: at least they are allowed nappies.

The foundational study in Labour Process Analysis from which (to simplify) grew Critical Management Studies, was Harry Braverman’s (1974) Labor and Monopoly Capital of which the subtitle was ‘the degradation of work in the twentieth century’. Half a century on and we seem to be seeing degradation at work as the defining feature of the labour process; an all too literal labour process when women give birth in toilets to avoid losing their jobs.

Tax but don't spend

Last February I wrote a post in which I peevishly listed various experiences of organizations not working very well. One item on the list concerned the problems of getting through the HMRC (the British tax office) on the telephone. So I was interested to see that this week the National Audit Office (NAO) published a report on HMRC’s quality of service. This identified a “collapse” in customer service over 18 months in 2014-15 with call waiting times tripling and some customers being kept on hold for up to an hour.

What lay behind this were massive cuts in staffing levels, which in personal tax fell from 26,000 to 15,000 between 2010-11 and 2014-15. This of course is just one of the many consequences emerging across all parts of the public sector as ‘austerity economics’ bites deep under the ideology that eliminating the government’s budget deficit is the sole aim of policy (what Nobel economist Joseph Stiglitz calls “deficit fetishism”). But there is more to it than that: associated with the cuts was the technocratic fantasy of paperless (on line) tax returns and automated telephony.

We’ll break here for another oldster rant: why does everything have to be done online, with endless passwords and usernames in hundreds of different formats? How I long for the days when you could just fill in a form and send a cheque in the post. There are still a few places you can do this and I would single out from my own experiences the insurance company NFU Mutual as particularly good not just for this but for that fact that they have an ordinary phone number that goes to the local office where I talk to a person I have met and who has been in post through all the years I have dealt with them. And, on the one occasion I’ve had to make a claim, they are excellent to deal with. Is it because they are a mutual organization?

Back to the HMRC and what is interesting is to note how this story illustrates some of the recurring – and linked - themes of my book, namely those of unintended consequences and of the ambiguity of efficiency. In terms of unintended consequences the issue is how cost savings in one budget show up as new costs somewhere else. This is especially obvious in relation to HMRC because an effective tax gathering system is vital to meet the costs of government spending departments. So to impinge on the first inevitably has consequences for the second.

The issue of efficiency is linked in that what may be efficient for the HMRC maybe inefficient for other departments but, beyond that, inefficient for the user – in this case the taxpayer or, as they are now called, with tragic inevitability, customers. And let’s just have another break here to remind ourselves how crass, how nonsensical, it is to describe people paying taxes as ‘customers’. The NAO Report is helpful in quantifying this by reference to the HMRC’s own costings of people’s time (£17 per hour, apparently). On this basis, the time spent waiting and talking, and the cost of the call, added up to £97M (of which £66M was the cost of waiting to be answered) in 2015-16. So HMRC’s efficiency savings become its “customers’” costs. According to the NAO and the HMRC things are now getting better, though I must say that this is not my personal experience and, anyway, we have been here before. A damning 2012 NAO Report on phone call waits was also met with promises of improved performance and assurances that this was beginning to happen.

There’s a bigger organizational story here. The HMRC is the result of a merger, in 2005, between what were previously the Inland Revenue and the Customs and Excise office. Culturally very different, many date the problems at HMRC from this archetypical example of reform through reorganization. Subsequently, there have been repeated high-profile scandals. Dave Hartnett, its boss until 2012 when he joined global accountancy firm Deloitte as a consultant, was accused of cutting lax ‘sweetheart deals’ with big corporates like Vodafone and Goldman Sachs, and called “a liar” by the chair of the Public Accounts Committee. His successor, Lin Homer – dubbed ‘Dame Disaster’ by satirists – was criticised for failures in relation to the HSBC tax scandal and also for claiming the HMRC to have had its best year ever in 2015 despite – yet again – massive problems with phone systems. She stood down in April 2016.

As for the future, who knows? HMRC have taken on more staff, but the ongoing closure of 137 local tax offices in favour of 13 regional centres does not bode well, and the latest NAO Report says that HMRC’s capacity to sustain planned cost reductions rest upon its Making Tax Digital initiative, another techno-fantasy, which has already been met with scepticism, if not outright derision, by tax accountants.

It’s tempting to ascribe all this to the well-attested failures of neo-liberal ideology in general and the effects of its application to the public sector in particular. But it’s more complex, and worse, than that. Even the most assiduous neo-liberal assumes, accepts and expects that the State will act as a ‘nightwatchman’, undertaking the basic functions of tax collection, law and policing. But cuts have “brought the court system close to breaking point” and are causing a crisis in policing and in the prison system. It used to be the leitmotif of anti-state ideologues that cuts could be achieved by getting rid of ‘five-a-say Czars’, ‘diversity officers’ and, of course, that perennial favourite ‘faceless bureaucrats’. Now it turns out that even the most basic functions of the state are up for grabs. If proof of that were needed, look no further than current plans to privatise the Land Registry, the body that administers that most basic feature of any capitalist economy, property ownership.

Turkeys and Christmas

Before the virtual ink had dried on my last post, the campaign for the UK to leave the EU produced their biggest and, so far, most pernicious, lie with the launch of a poster stating: “Turkey (population 76 million) is joining the EU”. The idea – signalled in the population figure – is to whip up fears of Turkish – meaning Muslim – immigration to the UK.

The lie is that Turkey is not joining the EU. They applied to do so in 1987 but negotiations did not start until 2005. Joining requires the opening and closing of 35 ‘chapters’ or areas of agreement, of which so far only 15 have been opened and just one closed. Turkey is nowhere near to joining the EU and in any case its joining could be vetoed by any member state and almost certainly would be. In some ways it is further than ever from joining because of its deteriorating human rights and democracy record. And, for that matter, Turkey itself is far less interested in EU membership than in the past: its longstanding failure to join has led it to reposition itself strategically away from Europe and towards being a middle-eastern regional power.

I don’t pretend to be an expert on Turkey or its EU negotiations, but the expert opinion is clear, as in this recent summary:

“To infer that Turkey may one day soon join the EU is to reveal a fundamental ignorance of the political and procedural realities of the EU and of its enlargement process. Turkish membership of the EU is at best a distant prospect.”

Reading – as, sadly, I do – many internet discussion forums about the EU Referendum it was interesting and depressing to see how the lie that ‘Turkey is joining the EU’ was defended. One line was to say – mendaciously – that the recent deal by ‘Germany’ to give Turks visa-free access to the Schengen zone meant that they had ‘free movement rights’. It doesn’t (three month visa-free travel is not the same as free movement) and, anyway, the deal may not go ahead because it is not ‘Germany’ that decides but the democratically elected EU Parliament which is blocking or at least modifying the deal which, for that matter, Turkey may not accept. And even if this were to happen then, of course, it would not mean that Turkish membership of the EU was any closer.

Another line of defence was downright peculiar. It was that ‘joining’ is the present continuous tense and therefore the poster was true since Turkey was ‘in the process’ of joining. This kind of sophistry gives sophistry a bad name. If I say that ‘I am joining the campaign to leave the EU’ any reasonable person would think that means that it is going to happen, not that I am in a process that might or might not end in the future in me becoming a member of the campaign.

The wider context for this anti-immigrant sentiment associated with a supposedly anti-elitist movement is the well-worn theme of how the consequences of economic crisis play out. It never has a happy ending, not least for the ‘ordinary, salt of the earth folk’ that the anti-elite elitists play for fools in the way that the Brexit advocates are currently trying to do. For their goal is not to help, sustain and support ‘ordinary people’ in the face of global capitalism, but to expose them to the most extreme form of unregulated global capitalism. Those who fall for it are voting, like the proverbial Turkeys, for Christmas.

Lies, damned lies, and statistics

The expression “there are lies, damned lies, and statistics” has never been definitively attributed but it has become a political cliché. And in some ways an unfair one, since it is a way of discrediting any and every statistic. Even so, there are some statistics which are palpably lies, and the campaign for Britain to leave the EU is replete with them.

The most egregious lie is the statistic used as the headline claim of the Leave campaign (appearing on the side of the campaign ‘battle bus’ and on all its leaflets and web sites) that “the EU costs us £350 million a week”.  This has been debunked numerous times, not least by the Office for National Statistics. It arises from the fact that in 2014, the last year for which full figures are available, the UK gross contribution to the EU was £18.8 billion. Divided by 52 this gives the figure of £350M per week. But stated as a cost to the UK it is a lie. Why?

Because it is the gross contribution. The net contribution is reduced by the UK’s budget rebate, which in 2014 was £4.4 billion, and payments received back in grants to for example agriculture and science funding which in 2014 were £6 billion. So the net contribution in 2014 was £8.4 billion – less than half what is claimed. And there is also the lie that this is what the UK pays ‘each year’. In fact, the figure varies each year and 2014 was the second highest contribution on record. Nor is the figure rising – the 2015 predicted out turn is lower than 2014.

In the face of this (although they have never acknowledged the fact that this was an unusually high year) the Leave campaign have made two defences. First, they say, that is the amount that we actually hand over, so it is what the EU costs, even if we get some back. That is a crazy logic in itself, of course. It is like saying that if I go into a shop and buy something priced at £5 and give a £10 note and get £5 change, then my visit to the shop has cost me £10. But it isn’t even true in this crazy sense: the rebate part is never even handed over.

Their second defence is that it is justified to quote the gross figure because, outside the EU, all this would be available to spend on what the UK wanted, whereas the £6 billion that comes back has to be spent on what the EU determines. The problem with that, though, is that Brexit campaigners have, whenever challenged that leaving would reduce UK agricultural subsidies or science funding, said that these payments would continue to be made by the UK government, and some have even said they would be increased. So if that is true, then only the net figure would be available to the UK.

But let’s look at that. First, it assumes that nothing else whatsoever changes in the economy on Brexit, which no analyst, even pro-Brexit, thinks. Second, it neglects how that contribution benefits the UK by, for example, boosting the economies of less developed members of the EU which in turn leads to demand for UK exports. Third, in 2014 it was about 1% of UK government expenditure anyway – almost a rounding error in the public accounts. And, fourth, the impact of the rebate (negotiated by Margaret Thatcher in 1984) is that the UK is exempt from the general rule of contributing 1% of GDP. The consequence is that in every single year the UK is the lowest contributing EU member as a percentage of GDP.

The zombie statistic of £350M a week refuses to die, no matter how often it is discredited, but it is not the only offender. This week, the Leave campaign produced what became a widely reported statistic supposedly showing that UK exports to the EU had dropped by over 18% in the last decade. The idea was to try to counter the argument that the single market is important to the UK economy. Buried in what they said was that this didn’t take account of exchange rate fluctuations between the pound and the Euro, which sounds rather boring and technical. But of course it is crucial. If a UK firm sells a good for £1 and the exchange rate is £1=2Euros and next month sells the same good at £1=1.5Euros then the value of exports has fallen by 25% - in Euros – but not at all in sterling. And in the period 2006-2016 the £-Euro exchange rate has fluctuated considerably.  So I checked and - surprise, surprise – the value of UK exports to the EU actually rose in sterling over the last decade. And that was a decade no doubt carefully chosen to encompass the global financial crisis – if one took the 20 years from 1996 the growth would be larger.

These two examples are taken from many that could be chosen, and this week several more were pulled apart by InFacts. The other headline lie, apart from the budget contribution, is that 65% of UK law is made in the EU when in fact is 13%. Of course in all political debates statistics are bandied about, and they are often dodgy, and the Remain campaign are surely guilty of cherry picking statistics to suit their cause. But that is not the same as lying and what I find extraordinary about the Leave campaign is not that they present figures that support their case, which would be one thing, but that every statistic I have seen them produce has been palpably – often absurdly – dishonest. Maybe I am biased – but if you think so watch Vote Leave’s Dominic Cummings being questioned by the Treasury Committee about the £350M a week claim, and judge for yourself.

Ageing badly

There is plenty of public discussion of the complex issues involved in being a parent, but far less about having parents. What I mean is the issues arising for people in middle-age having to care for and cope with their ageing parents. Those issues are made more complex by the way that families tend now to be dispersed geographically and the much longer live spans that are now common. The consequence is the necessity of engaging with the organization of care for the elderly. In the UK, at least, that organization is woefully inadequate and in crisis.

Longer live expectancy is both a consequence of medical care and a cause of the need for medical care. This in turn requires increased health expenditure, but in 2015 the UK health expenditure as a percentage of GDP was 8.5%: lower than Greece, lower than most west European countries, and far lower than the US. Against this, it has to be recognized that the UK system is far more efficient than others in translating expenditure into health outcomes. Maybe more important, though, is that increases in UK health expenditure don’t match increased costs (healthcare cost inflation is much higher than general price inflation) and increased demand (driven primarily by ageing).

But healthcare is only one part, and not necessarily the most important part, of the organization of ageing. Most health expenditure arises in the last two years of life; whether that life ends at 70 or 90. No, the real issue is the organization of care, and this is in complete crisis. Whereas it used to be provided mainly by local authorities, now there is a hybrid system of private care homes part-funded by local authorities. Budget cutbacks mean that the part-funding is increasingly inadequate; whilst the crazy financial engineering of some private home owners like the collapsed Southern Cross (discussed on p.115 of the book) exacerbates the problem.

The two aspects of health care and care homes are closely related. Both emergency and routine care departments of hospitals can’t discharge elderly patients because there is nowhere for them to go, especially if they are ‘unprofitable’ from a care home perspective. On the other hand, as a report this week highlights, in other cases the elderly are being discharged back to their own homes when they are incapable of coping, with horrific consequences.

All of this is absolutely to do with failures in the way that we organize. The privatized, often private equity firm-owned care home system is simply absurd, and passes on its inefficiencies to the public sector NHS. But beyond that is the obvious absurdity of dividing health and social care at all. There has been much talk of overcoming it, and some areas in England have made progress in doing so but overall the separation remains stubbornly in place.

As is often – perhaps always – the case, the issues relate to both organizations in the institutional sense (the structures of, in this case, health and social care) and to ideational organization (the construction of ‘health’ and ‘care’ as categories). Underlying the latter is perhaps also the more profound division of the public and private realms, so that health care is something that happens in the public domain of the hospital ward and social care something that happens in the private domain of the home (even if the home is an institutional ‘care home’). This in turn means that much suffering remains hidden (‘at home’) and experienced by both the elderly and their families as a ‘private’ problem, and possibly a stigma.

The psychology of this is undoubtedly very complex, since the relations between (adult, ageing) children and (aged) parents has the capacity to engender guilt, frustration, anger, fear and much else besides. Psychology has been much concerned with the relationships of children and parents in infancy, but perhaps much less so (at least, that’s my impression) with those in adulthood. The dynamics of the latter are surely taking new forms as extended old age and associated dependency become the norm rather than the exception.

In 1911 in the UK life expectancy was 51 years; by 2013 it was 81 years. In 1911 there were 107 people in Britain aged 100 or over; in 2013 there were 13,780. A similar pattern can be found across the developed world. Organizationally, and emotionally, we have not really caught up with these profound demographic changes.