It is time to end traditional trade unions and replace them with New Unions

Workers today badly need strong unions. But they don’t need the traditional trade unions of the 20th Century which are as obsolete as the traditional industries and socialist aspirations in which they were born. Labour is currently losing the battle against capital. In the 1950s and 1960s, Western labour and capital worked together pretty well. The returns to labour (wages, conditions, entitlements) rose steadily, whilst the returns on capital were actively reinvested into businesses and grew productivity. It went wrong in the 1970s. Labour got too greedy, it fought against change and the wheels came off. Increasing globalisation left uncompetitive businesses exposed. Capital fought back hard in the Reagan and Thatcher era, and won. Although the next generation of political leaders (Clinton, Blair, etc) used the state to ease the pain, labour has not recovered parity with capital since the battles of the 1980s. But workers need more than just politics to sort this out. Workers need unions who focus on helping their members as individuals to each earn the most money they can in the world we now have – a world of flexible jobs, global competition and technological disruption. They need their unions to be creative players in the economy, not commentators, politicians or protestors.  We need a set of New Unions. New Unions who have just one mission: to help each individual Member earn the most money they can, right now and into the future.  They should compete with each other for Members based on who delivers the best earnings. They should do all and anything they can to win this battle. They should offer a lifelong community, based on careers not particular jobs or employers, be multi-disciplinary so they don’t resist change and focus on total earnings, not an individual wage. If I was starting one of these New Unions, I would call it “EarnMore”. I am going to set out 8 things which an EarnMore could do to win its first 1m members and boost their net incomes.

But first let’s look at the starting point for New Unions. Or, rather, the end point of traditional trade unions.  83% of workers in OECD countries have chosen not to join a union. In the US, the proportion of workers in a trade union has fallen from 31% in 1980 to just 10% today. In the same period, it fell from 50% to 25% in the UK, from 49% to 17% in Australia, from 35% to 18% in Germany and from 19% to just 8% in France. Only the Scandinavian countries (with up to 68% in unions) and Belgium (at 55%) have a majority of their workers in a union. The UK, for example, illustrates the death of the union. Membership rates are just 14% in the private sector, 13% for low paid workers, 15% for temporary employees and 16% for smaller firms. 4 out of 10 members are over 50. Membership levels are only strong in the public services and utilities. In hotels and catering, for example, membership rates are just 4%. One reason for their decline is that much of their job has been done for them by governments. Employment legislation in western countries protects all workers (whether union members or not) against discrimination, dismissal, unsafe working, abusive wages and excessive hours. This problem is shown in France, where trade union membership has always been low and now is far and away the lowest in the OECD. But French workers enjoy the greatest employment protection in the OECD. For example, temporary workers have 10 times more protection in France than in the UK and 3 to 4  times more than Germany, Sweden and Japan But it’s not only employment protection legislation that has rendered traditional unions redundant. There has been a big growth in occupational licensing and regulation by Western governments. Typically, in European countries, a hundred or more jobs are now regulated. Across Europe, between 10-24% of the workforce has a regulated job. In the US, 30% of jobs are now licensed by the government, compared to just 4% in 1950. This licensing in the US and Europe adds a significant wage premium of up to 20%. In most countries, there are more licensed staff than there are trade union members. Trade unions have historically played a big role in campaigning for these employment rights and regulation, and opposing de-regulation and flexible employment. But they have in fact legislated themselves out of a job. The political landscape on employment issues is now a crowded space and traditional trade unions won’t be missed. Anyone who doubts this should look at the current high profile political debates in Western countries – how far to increase the minimum wage, how to liberalise European labour markets, how to reduce the gender pay gap or whether to allow more competition for licensed taxi drivers. Trade unions are no longer the main actors in these debates.

So if we abandon the traditional mission of achieving socialism through political action, what can unions actually do to help their members earn more, now and in the future? One place to look for insight is 15th Century Italy, in Florence. Modern capitalism started in Florence.  It invented investment banking, merchants, the industrial city, patents, trademarks and the trade union. The Florentine union, or “guild” as it was known in the 15th Century, was much more powerful than a modern trade union. The guilds incorporated the city’s businesses and nominated the city’s government. They trained workers, organised trade, protected intellectual property, provided welfare to members’ families and support services (like watchmen) to members’ businesses. Becoming a member of a guild was the route to a skill (through the apprenticeship route to master or even grandmaster level) and to a commercial income (through the protection a licence offered against competition). It was also the route to social and political status. There were 3 levels of guild – Arti Maggiori (the 7 major guilds like lawyers, bankers and doctors); Arti Mediane (the 5 middle guilds like butchers, masons and smiths); Arti Minori (the 9 minor guilds of inn keepers, carpenters, bakers and wine sellers).  But the majority of the population (the Minute Populo) were not even allowed to form or join a guild. This included skilled workers like weavers and boatmen who all remained waged staff. To cut a long story short, the Arti Maggiore became all powerful. Other guilds gradually disappeared as they got in the way of the new capitalist merchants. In the end all of Florence’s guilds were abolished in 1770. The legacy, though, is profound. Today’s Arti Maggiore have many of the characteristics of a Florentine guild. Law, medicine, banking and accountancy: all have tightly regulated professions; they group together to train their apprentices; form partnerships to maximise individual incomes; exclude competition through regulation; enjoy high returns on their scarcity and barriers to entry. The most affluent in our societies are doing really well out of employment unions. Many middling occupations (the equivalent of the Arti Mediane and Minori) have retained the protected trade mix of self-employment and state regulation, e.g. bar owners, taxi drivers or electricians. And the great majority (the Minute Popolo) have remained dependent employees with limited occupational regulation or economic power. We undoubtedly need to tackle the self-interest of today’s Arti Maggiori where they conflict with consumers’ best interests, as they often do. But we also need to help the Mediane, the Minori and, most importantly of all, the Minuto to emulate the economic power of today’s Maggiori. That’s the role of the New Unions.

Here are 8 ideas for New Unions to provoke debate:

  1. Totally replace employment agencies – In the EU, 1 in 7 workers (14%) are on temporary contracts. In some countries (e.g. Poland, Spain, Netherlands) this increases to 1 in 4 workers, or more. The proportion is much lower in countries where it is easier to hire and fire permanent staff (e.g. just 6% in the UK and Australia). Unionisation of temporary workers can be very low. In the UK, for example, only 15% are in a union (vs 25% of the total workforce). Employment agencies are often the best hope for temporary staff, as they are heavily incentivised to match jobs and people. Using the UK as an example, employment agencies place about 700,000 people a year in temporary jobs and about 1.2m people are on a temporary contract secured by an agency.  It’s big business, with revenues of £33 billion last year. There are 11,000 agencies employing almost 96,000 staff. That means there as many as staff in agencies as there are union representatives in the UK. The New Unions should take on these roles. The margins of 20-30% provide a good source of attractive dividends for their members. But more importantly, if the purpose of the New Unions is to maximise staff (rather than shareholder) returns, they can create economic power for their members. This might mean that permanent employees opt to become temporary ones.  We can already see this happening in the UK in healthcare and education (with nurses and teachers choosing agency work as higher paid than regular contracts). A halfway house may be that employers hire staff but they are obliged in the deal to use the particular New Union’s terms, conditions and contract not have their own.
  2. Create a sharing economy within the New Union – A New Union should aggressively drive sharing between Members to help them earn more. A simple example might be childcare. For many parents, the cost of paid childcare is prohibitive, limiting how much work parents can afford to take on. Or if they do pay for childcare, greatly reducing their net income from working. But let’s think differently. Think of a parent working 3 days per week and spending 2 days at home with a young child. That parent could provide free childcare to another parent on 1 or both of those days that they are at home with their own child, in exchange for free childcare for their own child when they are at work. This could transform net income for working parents. Babysitting circles have worked on the same principle for a long time. Similarly, within the New Union, people could exchange or buy the downtime of other members’ tools, vehicles, workshops, offices,etc. Members could sell car sharing to each other for commuting and provide cover for each other to reduce losses due to illness or emergency leave. They might earn a paid commission from other Members for finding them extra work.
  3. Own and expand the “Gig Economy” for Members – The New Unions should compete to offer the best digital solutions to help their Members earn more money. That means, for example, having their own version of Task Rabbit or Uber. It requires New Unions to use the same means as private companies (digital marketplaces, consumer rating of workers, simple apps, etc) but having a different end (the enrichment of Members rather than shareholders). As well as the technology itself, there is lot to learn from the tech economy. This includes providing attractive, flexible workspace in a club-like environment. It means holding frequent networking events, providing mentors and crowdsourcing funding. But owning the Gig Economy means looking beyond tech. For example, many lessons come from looking at immigrant communities in Western countries. For example, Pakistani employment communities have developed in many British cities, often dominating the taxi and restaurant industries with intra-community capital, networking, purchasing and employment. A wide variety of communities exist to connect people with opportunities, including Alumni groups, Soroptomists, Chambers of Commerce, Freemasons, Rotary Clubs, etc. This is the spirit of mutualism, solidarity and serendipity that New Unions need to copy.
  4. Become a welfare provider, over and above whatever the state offers – A New Union should offer a social insurance for its members. The need for this varies by country. For example, in the US, the pressing need is for maternity leave benefits. Only 13% of women have the right to paid maternity leave. A quarter of new mothers are back at work within 2 weeks of the birth. In other countries, like Britain, where most employment benefits are means-tested, the New Union could offer premium benefits over and above the State funding or legal rights. But the New Unions can be more inventive. For example, they could provide student-style halls of residence to help their members move to high employment areas. Teney could go further and offer a wide range of financial products. Too many work-related financial products (pensions, insurance, savings schemes, unit trusts) offer poor value to their users. A New Union could create high-trust, low-cost products, e.g. a pension fund with a 0.2%, not 2%, annual fee. The funding of this extra welfare could work in 4 ways: employees paying a monthly deduction into a Union insurance scheme; the New Union using it’s bargaining power with employers to get a greater contribution from them for Union members; having an opt-out from State schemes, where instead of paying social insurance to the State individuals and employers pay into a New Union scheme instead; using the Union’s income surplus (e.g. from commission for temporary staff) to fund member benefits.
  5. Replace government regulation of staff with New Union accreditation – The state regulation of jobs has got out of hand. Instead of looking for market solutions, too often governments respond to consumer concern about issues by regulating jobs. This can mean issuing state licences, requiring certain qualifications or experience. Not only does this impede market innovation, over time it allows the regulated staff to assert their interests before those of consumers or competitors. Research shows that licensing regimes which were in place 40 years ago or more give workers a 30% wage premium. Those established in the last 20 years offer a premium of just 4%. The extent of job regulation is remarkable. In the US, for example, 21 states require tourist guides to be licensed. In Nevada that means 733 days of training and a $1500 fee. In Tennessee, a “shampooer” in a hairdressing salon requires 700 days training, 2 examinations and a licence fee. A different approach would be for the State to withdraw from many areas of regulating individual workers. Instead, where Governments feel that some regulation is necessary, they could license New Unions to run their own schemes. For example, my New Union “EarnMore” might train, accredit and discipline its own home care assistants – just like many professional associations would do. Employers would hire the home care assistants because it trusted “EarnMore” accreditation. If EarnMore doesn’t do it well enough, employers would choose to recruit members of other New Unions. Consumers could come to respect and request the EarnMore workers. This would build brand value for workers. Workers would join the New Union that offered the the best way to be licensed and helped them earn the most money. This would be a market-based solution.
  6. Recruit and support the self-employed – The traditional union has neglected the self-employed as their mindset has been about imposing things on employers. However, many self-employed people are not affluent and some are very poor. They need the support of an employment union as much as anyone else. In the EU, 1 in 6 workers (17%) are already self-employed. This is much higher in Greece (37%) and Italy (25%). With the exception of the UK (17%), self-employment is lower in the English-speaking world (e.g. US 7%, Canada 9%, Australia 10%). But the trend towards more self-employment looks certain. Many employees are also self-employed part-time. With a philosophy of “EarnMore”, New Unions need to be help more people become self-employed, at least part of their time, to maximise their earnings. A New Union can offer a full set of administrative support e.g. bookkeeping, payroll, insurance, office services. They could offer peer-to-peer support within the Union, including mentoring, collaboration, procurement and financing. And they can offer all the other benefits of a New Union (internal sharing, the Gig Economy, temporary work, welfare, etc) to the self-employed.
  7. Turn employees into shareholders – An important way for New Union members to earn more is to have equity in the companies for which they work so that they profit from the profits made. New Unions should have an aggressive agenda to increase employee ownership. This might be full ownership, like the UK’s success stories in John Lewis (with 87,000 staff) or professional service firms like Mott MacDonald or Arup (with a combined 26,000) or the health and social care firms like Sunderland Home Care Associates and Central Surrey Health. Or it might be partial ownership, where staff buy or earn equity, like senior executives do, or how start-up firms incentivise their staff in the early years.
  8. Provide world class learning and development – A key route to earning more is gaining skills and having them accredited. Too many vocational colleges are poor and too many employers fail to offer high quality development. For staff who move between employers or even countries and for self-employed, they need the ongoing support they can’t get from any current job. The New Unions should have learning and development as a central mission. This means organising apprenticeships and other initial training. But it also means lifelong learning. New Unions could use digital learning to create their own Academies. These would not only train Members but also create online professional communities where people collaborate, mentor, counsel and share best practice, top tips and connections.The New Unions should accredit all development, with both proprietary branding (e.g. being an EarnMore Master or Grandmaster) and transferable credits with other New Unions’ accreditation schemes. The New Unions should have active plans and communities to better their members’ interests – e.g. support groups for women in their 30s who are juggling family responsibilities with career progression. The New Unions should also reach out to those who are not in work, taking over welfare-to-work and other employment programmes. They could fill the vacuum in the market for high quality careers information and guidance. How could all this be paid for? Firstly, done digitally and using peer-to-peer approaches, the costs could be managed down. Secondly, the New Unions could take over from traditional vocational colleges (FE in the UK, TAFE in Australia or Community Colleges in the US) and take on their state funding. The New Unions could also take over a lot of other state funding going into apprenticeships, welfare to work and other programmes. A proportion of the funding would come from subscription fees and some of it would come from additional purchases from individual members and employers.

So what’s to stop these New Unions happening? The traditional unions need to step aside or reinvent themselves. Governments need to roll back the legislative approach to employment and create the space for the market solutions of New Unions to take over. Governments also need to give New Unions access to funding, e.g. for training and to allow members to opt-out of some state welfare schemes and put their money into the New Union. They also need to give New Unions a legal status to play its role in the wider regulatory systems. And New Unions need regulation too, e.g. they shouldn’t be allowed to have more than 30% of employees in any geography or industry. But most of all what is needed is for dynamic Social Entrepreneurs to come forwards, start-up the New Unions and attract paying members. Entrepreneurs, not bureaucratic socialists, are what ordinary workers need, helping them to get stuck into the modern economy, become winners and shape the world they live in. The New Unions would combine social solidarity with capitalist dynamism. Labour can have parity with capital again. Ordinary people can earn more.

Do we still need prisons?

There’s no shortage of people worrying about the world running out of things. Oil, water, food, antibiotics, polar ice – they all have people worried. But no-one seems to be worrying about the shortage of something that’s essential to social justice. We are running out of punishments. As societies become more civilised, they find punishing other humans less and less attractive. This is a new problem. For most of their history, humans have been disturbingly inventive in devising punishments for rule-breakers. People have been burned, hung-drawn-and-quartered, flogged, enslaved, exiled, relieved of their fingers, branded, transported, stoned, had their heads shaved, been tarred-and-feathered and put in the stocks – to name just a few. Most punishments have been physical ones – death, mutilation or beating. In Western Europe, we often forget that most people in the world (over 60%) live in countries which still use the death penalty. But most of them don’t use it very often. Perhaps surprisingly, fewer countries still use corporal punishment – only 33 countries, a mix of Islamic countries or former British colonies which kept the British tradition of flogging. As countries have abandoned, or at least reduced their use of, physical punishment, they have tended to fall back on imprisonment as the only remaining “serious” punishment. In many Western countries, unless a convicted offender is sent to prison they are seen by much of the public (and the media) as having “got off with it”. A UK poll showed that 80% of the public and 90% of the police thought non-custodial sentences were “soft punishment”. Whilst many of the public said prison didn’t work, two-thirds of them thought that was because sentences were too short and prison life too lenient. The punitive alternatives to prison are not obvious. Serious financial penalties are hard to impose on poor people, so they aren’t. And most people in prison are poor people. US data shows that, before going to prison, prisoners had only 50% of the median income of their ethnic and age group, e.g. young hispanics in prison had only half the income of other young hispanics. Many fines are not repaid. The UK Government, for example, has written off hundreds of millions of pounds of fines in recent years. The penalty for not paying a fine, of course, is to go to prison. But imprisonment has its opponents too. We know what most offenders need to avoid re-offending:  a home, a job, a loving relationship, self-esteem and a positive peer group. We also know that the biggest threat to all these is being sent to prison. Indeed, that is the explicit point of prison – to remove what people most value in the world. It feels as though the West is at a turning point in its use of prison. The US is considering big cuts to mandatory sentences. Europe is struggling to afford it’s prison population. The UK and others are recognising that prison isn’t the right solution for many prisoners such as the seriously mentally ill.  But if we stop imprisoning people, what punishments will we have left for serious crime or where offenders don’t respond to other punishments or interventions? Yes, justice is about rehabilitation and restoration. Prison does seem a bad route to these goals for too many offenders. But justice is also about retribution, deterrence and incapacitation. Only prison currently seems to deliver for the public on those goals. (Anyone who doubts this should look at the Netherlands where liberal sentencing has led to empty jails but politicians who are unwilling to be seen closing prisons. Instead, the Dutch are housing Belgian and Norwegian prisoners to fill their prisons.) So, if it’s all we’ve got left, will prison be the last of the brutal punishments to survive and how could it evolve?

It’s tempting to think that imprisonment has been used as a punishment, like capital and corporal punishment, for thousands of years. But that’s not true. It’s a fairly modern invention and has changed in nature hugely since it was introduced. Before the 17th century, a prison was used simply to hold people pending a trial or a punishment. It was not a punishment in itself. In fact, modern prisons were a cuckoo that took over a different nest. The first modern prison is usually seen to the London Bridewell.  But this was initially a house of corrections for the poor, vagrant and homeless, aiming to take them off the streets and instil a work ethic into them. This side of it was widely replicated as “Workhouses”. But the idea got taken over by prisons. It was the public reaction in England against death sentences in the late 18th century that led to the growth of prison, hard labour and transportation as common sentences. At its peak in 1800, there were 220 offences that could earn a death sentence in an English court, most of them trivial. Juries would sometimes refuse to find someone guilty of minor theft or poaching to avoid the sentence. Even if issued, death sentences were mostly commuted – only 7,000 out of 35,000 English death sentences between 1770 and 1830 were carried out. As the use of prison grew, there was growing Western social science and philosophy about the best sort of regimes to optimise punishment and rehabilitation. For much of the 19th century, this often meant separation of all prisoners (effectively solitary confinement), silence and continuous hard labour. It was taken for granted that prisoners would be beaten whilst in prison. In the US, for example, late 19th century prisons tortured prisoners with a water coffin, iron cages on their heads and frequent use of the lash and paddle. Flogging in prisons has disappeared only fairly recently, e.g 1962 in the UK and 1972 in the US. Most Western prison regimes are now pretty similar. What varies enormously is the proportion of the population who are imprisoned. The US has increased its state and federal prison population from 320,000 in 1980 to 1,560,000 at the end of 2014 – a 380% growth. If we add in, the 700,000 in local jails and detention centres, there are 2.3m Americans in prison. Per head of population, the US imprisons 10 times more people than Germany or Denmark. The UK and Australia have pretty big prison populations, with an imprisonment rate roughly double that of the Scandinavian countries. The UK has doubled its prison population in the last 20 years. But the US has 20% of the world’s prison population, versus 5% of the world population. 7% of babies born today in the US will go to prison. There is a 70% chance that a black man born in 1975 who dropped out of school will spend time in prison and 1 in 3 black men will spend time in prison. The US “experiment” offers us the chance to see whether prison works in terms of deterrence and rehabilitation. A major study of US prisoners released in 2005 followed their progress for 5 years to 2010. Unfortunately, the results are appalling. 3 out 4 prisoners were arrested within 5 years of their release – many within the first year of release. And 16% of the released prisoners comprised a full half of all arrests in the US in the next 5 years. The data on “frequent fliers” in prison is depressing. In New York City, for example, the 800 most frequently jailed individuals between 2008-13 had 18,713 incarcerations. That’s 22 each. One person was jailed 66 times. 9 out of 10 offences were misdemeanours. Looking at the frequent fliers, 84% used crack/cocaine, 37% used heroin, 52% were homeless and 37% needed anti-psychotic drugs in prison. This picture is repeated in other Western countries.

In terms of rehabilitation, prison looks like a bad solution. But there are a lot of other potential benefits from depriving offenders of their liberty. It prevents them committing crimes whilst locked up. It can deny them access to harmful drugs. It can disrupt their social network. It can offer them a supervised opportunity to reflect on their offences, change their behaviour and plan for a better future. And it can satisfy society’s demand for retribution. So whilst there are many other policy issues about prison (e.g. better early prevention of criminal behaviour; decriminalisation of drugs; etc), we need some new ways to use imprisonment that can be sold to, and involve, the public as credible and well-understood punishments. This could include:

  1. House Arrest – The question is partly ‘how we can simulate its benefits without sending people to prison?’. But it’s also ‘how we can satisfy the public’s desire for retribution and incapacitation?’. The answer requires us to be tougher on removing the civil liberties of convicted offenders who are not sent to prison. For example, in prison, an offender loses all privacy and is under observation at all times, including, for example, when mixing with others, when in bed or even when using the toilet. If non-prison sentences could be this draconian in removing liberties, then a better alternative to prison could still be created, that still satisfies public desire for retribution and supervision. The alternative should be just that – a better option for those who would otherwise be sent to prison, rather than a way of toughening-up existing non-custodial sentences. So, civil libertarians please note, whilst my alternative is draconian, it is much better than prison. There are already sentences that limit people’s liberty in the community – home detention in New Zealand and Italy, house arrest in the US, electronic tagging in the UK, curfew orders and drug testing in the US. But they lack a strong brand and the ingredients of the sentence are often random and unpredictable – undermining their purpose in satisfying the public’s demand for justice. In Canada, for example, the Government has eliminated ‘house arrest’ for many crimes in the last few years and insisted on prison.  Let’s consider a new formal sentence called “House Arrest”. Sentences would include a fixed package of the community sentences currently available to the courts in many countries, including curfews, electronic tags, bans on meeting certain people, drug and sobriety testing, unpaid work, etc. However, it could be extended to include other restrictions and intrusions to simulate prison. This might include having all rooms in the offender’s home monitored for images and sounds on webcams, censorship of communication or bans on using phones or computers. Again, simulating prison, the offender could be allowed a certain amount of time when they were not “banged up” in the home and where, under supervision, they are out allowed to exercise or work, whether paid or unpaid.  An example of such a sentence for a 12 month sentence of House Arrest for an unemployed single man might include a requirement to:  be in his designated home for 21 hours per day, wear a GPS electronic tag, pass weekly blood tests for illegal drugs, avoid meeting or communicating with a list of specified people, have a webcam monitoring each room and achieve functional literacy. By contrast, a woman with young children might be sentenced to 24 months of House Arrest to include, for example: a requirement to be in the designated home for 16 hours per day, continue to do her job for 6 hours per day, as well as take children to and from school, etc. She might be required to wear not just a GPS tag, but also a sobriety tag and be required not to associate with certain people or visit a list of named places. Her ability to leave the house for 8 hours per day could be subject to her continuing to be employed, her children attending school and her successful completion of a drug addiction programme. Whilst in the house, she might also have to do unpaid work (e.g. online or telephone work) for a certain number of hours per week. It’s important that House Arrest sentences are predictable and comes as a entire package. Sentencing guidelines should set out a clear tariff of what total package comes for which offence and when house arrest should be used rather than a custodial sentence.
  2. Deferred sentences – The threat of going to prison is a big one. Clearly, it’s not a strong enough deterrent for everybody or no-one would commit crime. However, there is a way to use it’s deterrence when it would be most effective. That is when someone has been convicted of a crime and sentenced to prison. At that moment, the hope of avoiding prison (e.g. not being caught, or winning in court, or a getting a non-custodial sentence) has disappeared. At this moment, a conditional sentence could be hugely powerful. A court could say “In 12 months from today, you will go to prison for 2 years unless you meet certain criteria”. These criteria could include, for example:  having been employed continuously for a certain time, having clean drug tests, becoming functionally literate, paying maintenance for a child, sticking to a curfew order and successfully completing an accredited programme to reduce aggressive behaviour. Being convicted of another crime during the conditional period would automatically initiate the custodial sentence. However, a deferred sentence is different to a suspended sentence. With the latter, if someone does something bad they go to prison. With a deferred sentence, someone goes to prison unless they do good. A range of US states (e.g. NY, Texas, Washington) use “deferred sentencing” where in exchange for a guilty plea they adjourn sentencing for a period. If during that period an offender meets the court’s requirements the case will be dismissed with no sentence and, in some States, no criminal record. If the court’s requirements are not met, the offender will be sentenced.  This approach could work well with many offenders. However, my deferred sentence (rather than sentencing) is tougher and necessary to carry public confidence in many cases.
  3. Adult fostering – Many people in prison are vulnerable adults, who failed to cope outside and whose vulnerability is often made worse in a prison environment. This includes people with learning difficulties, mental health problems and poor life skills. It also includes people without family support (e.g. 1 in 4 prisoners have been in public care as children). However, many of these prisoners are a real social nuisance and /or at risk of harming themselves. Partly for punishment and partly for want of anywhere else to send them, they end up in prison to be housed and supervised. An alternative approach in such cases would be adult fostering schemes, where they live with and are closely supervised by a family, in a similar way to children being fostered under state supervision up to the age of 18. For example, the UK has an NGO called Shared Lives, offering 12,000 vulnerable adults a foster home. This concept could be extended to take people on sentence, with many of the conditions outlined in the Home Arrest option (e.g. curfews and staying off drugs)  but housing them with a supportive, well-trained and well-paid family. This would still be cheaper than prison. One option is for the foster parents to have full parental / guardian rights (irrespective of the age of the offender) and control the offender’s money and key life decisions during the sentence. They should also have the right to recommend that an un-cooperative offender goes to prison.
  4. Flexi-prison – Sending people to prison full-time deprives many of them of their jobs, their marriages or relationships, their homes, their family / social structure and their income. On the one hand that is what makes it a punishment. On the other hand, the things which are lost are the things which prevent reoffending. A balance could be struck if prison was part-time for some people. This could allow people to both lose what is important to them and their future, for part of the time, and to keep it too, for the other part. A part-time sentence might, for example, require that over a 12 month period the offender serves 100 days (24 hours long) in prison, equivalent to most weekends plus annual leave from a job. Or it might stipulate that every weekend and 1 named night each week are spent in prison. Or that people need to find a job that works at weekends and attend prison during the week. Some people, if they can plan it and give enough notice, may be able to arrange things so they can manage a 60 day stint in one go, without losing their home or job.
  5. Japanese Hogo-shi – One of the biggest problems about prison is that it takes, mostly, socially excluded people and excludes them even further from society. Hardly anybody from mainstream society visits or engages with prisoners. There is a lot to learn from the Japanese system of probation (Hogo-shi). Unlike Western countries, 98% of the State’s 49,000 probation officers are volunteers. They have the status of part-time but unpaid civil servants. They supervise and give support to 40,000 offenders on parole and probation. They mostly use their own homes to meet the offenders. They commit to working with the offender’s family, help them find jobs and make social connections. Post-prison Hogo-shi halves re-offending rates. I think this would be a great idea for non-custodial sentences in other countries. But we could take this idea a step further. Whenever a person is sentenced to prison, part of the sentence could be that they accept the supervision and support of a volunteer probation officer. The prisoner could be required to meet the volunteer prison officer at least once a week and they could enjoy visiting and communication rights similar to a lawyer. The volunteer probation officer could be a formal part of any decision-making about the prisoner (e.g. education, therapy, moving prison, internal sanctions, parole, exit plans, etc). Critically, part of the sentence would be to fully co-operate with the volunteer probation officer for a defined period after leaving prison (e.g. 12 months) and for the volunteer to play an active role in helping the prisoner get a job, a home, stay clean, sort out any benefits and keep out-of-trouble. Like other probation officers, they would have the right to take offenders back to court if they are breaching their sentences. This would have the added benefit of opening-up prisons to the community and reconnecting the excluded with many privileged and compassionate individuals. If every prisoner had one volunteer probation officer, we would have some 60,000 new people involved in our criminal justice system.
  6. New Psychiatric Prisons – We can’t get away from the problem that too many seriously mentally ill people end up in prison because there’s nothing better for them. Mental health services are generally dreadful in most Western countries. But there is a particular problem about prisons. In the US, 40% of people with serious mental illnesses have been in jail at sometime. 20% of the US prison population at any one time has serious mental illness. Of this group, 90% have been in prison before and 31% have been in prison 10 times, or more. Like other Western countries, the US radically reduced the institutionalisation of the mentally ill by closing hospitals. It reduced the number of psychiatric beds by half-a-million (90% reduction between 1955 and 2005, despite a rising population). Since then, the mentally ill prison population has increased by some 400,000. In the UK, there were 150,000 people living in 120 “Lunatic Asylums” in 1955. Today there are just 18,000 in-patient psychiatric beds in the NHS. That number is just half of what it was 20 years ago, and falling. Meanwhile in the UK the prison population has quadrupled since 1955 and doubled even in the last 20 years. It’s contentious and speculative to say that most of those people in Western countries who would have been in mental institutions were just re-institutionalised into prisons. But clearly many were. And too many. The bigger job is to fix mental health services in the community. But a part of that is create a large number of appropriate and dedicated custodial facilities for seriously ill people who have to be imprisoned, but who are highly vulnerable, often terrified and in need of treatment. Such institutions need to find appropriate ways to punish as well as to treat and to care, but putting such ill people in a general prison environment is a disgrace.
  7. Hard Labour – Prison and labour were for a long time seen to be a combined package when people were sent to prison. But the West’s use of labour for prisoners has declined. During the 19th century, prison labour was mostly designed to be pointless. This included: turning a crank handle thousands of time in silence every day, moving cannonballs from one spot to another or powering a treadmill with one’s feet. In both cases, the labour achieved nothing. Convict labour gangs were widely used in the Southern USA, but too often looked like a new form of slavery to remain acceptable. In the 20th Century, some prisons have had useful voluntary labour, e.g. sewing mailbags or creating licence plates. There are some really inspiring work programmes, e.g. the Timpson’s scheme in the UK to train prisoners to be cobblers with the promise of a job when released. But forced labour for prisoners has disappeared from Western jails. Unpaid work in the community as an alternative to prison has struggled to convince the public that it’s a serious punishment. Unpaid, hard, mandatory and purposeful work needs to be built back into prison sentences and to remain a commitment when offenders are released under licence. Civil libertarians hate forced labour. But it would mean that prisoners were unlocked from their cells, usefully occupied and, where it makes sense, taken out into the community to do the work. Work is good for mental and physical fitness. And a good preparation for life outside prison. But where will the work come from? One solution would be to place a statutory duty on local government to create sufficient forced labour schemes and to use online voting locally to allow local people to choose what work they most want from their prisoners. This can be white collar as well as blue collar work. And if local businesses benefit from the work done, good luck to them, so long as the public backed the option.

If prison is the only remaining serious punishment, we do need to re-imagine how we use it. Hopefully, my options will stimulate people to think of better ones. Alternatively, those more imaginative than me might come up with a totally new punishment that strikes the right balance between public retribution and the dignity of the offender. In Dante’s inferno, the nine circles of Hell include unique punishment for each sort of sin: e.g. pushing boulders (for hoarders); being immersed in human excrement (for flatterers); wearing a cloak of lead (for hypocrites); being permanently lodged headfirst in a block of ice (for betrayers of family); or, being chased and bitten by reptiles (thieves). But in our real world, the options may be more limited.

Let’s call time on libraries, the BBC and art galleries and unleash a cultural renaissance

We know that long-term economic success requires creative destruction of existing industries in order that innovation triumphs over obsolescence. We also know that the short-term pain of creative destruction is real and politically unattractive. And yet we might expect that creative destruction would be at its strongest in our, well, creative industries. But actually there is such a lot of tax-payer funded protectionism that some parts of our creative institutions are becoming obsolescent and facing a sad decline. The UK is much more at ease privatising drinking water than reforming the “High Culture” industry. But we must tackle “Creative Protectionism”, so where do we start?

Like most other Northern working class boys of my era, I grew up oblivious to High Culture. But I had the (almost corny) experience of being rescued by a passionate teacher of English Literature, who intervened when I was threatened with explusion. He wasn’t even my class teacher. But he gave up his free time to immerse me in the Literary Pantheon. The more obscure or difficult the text, the more important I knew it to be. I couldn’t get enough of it and he pushed me off to read a degree in English at Oxford, the first person from my school to go there. But I was poleaxed at the first lecture I attended when a Marxist professor argued that the whole edifice of “Great Literature” was constructed solely for the economic benefit of publishers and academics whose livelihoods depended on a continuing demand for what they in particular knew, owned and could sell. This seemed just too cynical until I attended my first tutorial. Embarking on a compulsory course in Anglo Saxon, my charming old buffer of a tutor explained that he was one of less than 50 people left in the world who could proficiently speak and write in Anglo Saxon. He had himself been taught by Tolkien. He was sweet enough to explain that until his tenured generation retired we would all have to learn this language because there was nothing else they knew or could teach. (The compulsory course died with them.) And then I met and became great friends with a truly gifted young academic and author, who rejected the almost certain chance to teach literature at Oxford or become the next Dario Fo as elitist nonsense. He chose (successfully) to write TV soap opera scripts for a living. He was clear that literary merit in something watched by millions of ordinary people was worth much more than teaching dead poets to posh kids at Oxford or being feted by a few thousand government-subsidised rich theatre-goers. These formative experiences have set my enduring principles for public policy on culture – the importance of giving everyone, irrespective of background, inspiring access to the best cultural experiences; the need to avoid funding being permanently tied-up in out-of-date priorities, defended by those whose self-interest is threatened by change; the need to create new cultural giants, not just curate the old ones; the overwhelming importance of improving the everyday cultural experience of the majority, rather than occasional events for the minority.
If these sound like good principles, how is the UK doing right now? Well, the sheer scale of cultural opportunities available is overwhelming and exploding. And it’s about more than the internet. There are now 350 UK literary festivals each year (compared to just 3 of them 30 years ago) and hundreds more music festivals. London’s top museums are world beaters (e.g. the British Museum had nearly 7m visitor last year, up 40% on a decade ago). The headline art exhibitions sell-out and attract astonishing numbers (e.g. David Hockney’s most recent, and wonderful, London show attracted nearly three-quarters of a million of people). London’s 45 theatres attracted an audience of nearly 15m last year, up by half on 30 years ago, and offering 270 new productions and filling three-quarters of the seats. The number of new books being published each year keeps rising and the sale of translated books has risen by 30% in the last decade. The art form of choice for young men is poetry – with thousands of them writing and performing rap music. And then there is the internet. 100 hours of video are uploaded onto YouTube every minute of the day and YouTube gets 1 billion views a day. A quarter of billion people are active on twitter and a billion on Facebook, wanting to be followed and sharing what they’ve read, heard or seen from all over the world. There are more than 12m active bloggers self-publishing their work. Digital technology is giving us instant access to a huge heritage stock of culture. We have 500 years of music to listen to, 100 years of cinema and 60 years of TV to watch, along with 700 years of paintings and 2000 years of literature and sculpture to admire. And then we can share what we find.

Cultural fashions come and go. In the market, this works fine when the consumer is king. Money follows preferences at, often, great speed. So today’s UK cinema audiences are just one-tenth of their peak in the late 1940s. But they have tripled from the lowest ever point in 1984 when home videos first appeared. Antique furniture is another case study. Victorian and Edwardian furniture became fashionable and valuable in the 1990s, but in the last decade the price of Victorian and Edwardian furniture has fallen by two-thirds. In fact, the price of all antique furniture has fallen by a third in that period and continues to decline. In neither case has the Government felt the need to intervene. It hasn’t kept open surplus cinemas or asked the Bank of England to buy surplus Victorian furniture to keep prices high. Furniture and cinema are two cultural markets where the government doesn’t get much involved. But there is no real rhyme or reason to taxpayer intervention in culture. So, Government spends £1 billion each year on libraries, but virtually nothing on creating new literature. Taxpayers are obliged (on pain of going to prison) to put more than £2 billion each year into TV shows which look just the same as the free-to-watch content on the commercial channels. Classical musicians who perform (often pretty average) music created hundreds of years ago are handsomely looked after by the taxpayer but experimental pop musicians who create new music receive nothing. Billions of pounds is tied-up in operating bricks-and-mortar (e.g. Victorian art galleries) whilst broadband infrastructure (giving digital access, for example, to the world’s galleries) remains poor in many areas. The richest people in the world are given generous subsidies to watch opera in London (reducing their tickets to £175), whilst lower-income families have no hope of affording the average £50 ticket for a popular West End theatre production.

But it’s not just that public spending is arbitrary. Perhaps even more important is that those spending our taxes on culture are satisfying fewer and fewer consumers. Public spending is driven by inertia, giving money to the same things year after year. And if anyone challenges that spending, they will be met by a ferocious, well organised and deafening lobby protecting the status quo. This is usually enough to deter most politicians from asking too many questions. I am yet to meet the politician who doesn’t fear the roar of the librarian, the armchair grumbling of the Radio 4 listener or the eyebrow arching of the ballet-loving plutocrat. But in the last year only 20% of people went to an art gallery or exhibition, just 20% saw a play in a theatre, only 4% went to an opera or a dance event. More striking is how few people were publicly creative themselves- only about 1 in 50 sang, played an instrument, published their writing or took part in a play. If so few people consume or create “The Arts”, why is the political lobby for them so strong? Clearly, they trade heavily on the lazy assumption that “The Arts” are morally and spiritually good for people and that without them civilised values would quickly fall apart. But they also have a brilliant self-serving defence mechanism – the less that anyone wants the particular cultural service, the stronger the moral argument to protect it from the market and the greater the need for public subsidy. Libraries are a good example of this. 74% of people believe libraries are important for the wider community but only 47% believe they are important for themselves; only 36% of adults actually visit a library and only 17% of people borrow books. Indeed, adult lending (of both books and audio-visual) has halved since 2000, with book borrowing now largely focused on children and prolific adult readers. Each time a book is borrowed from a public library it costs the taxpayer about £4. That’s about the wholesale price of a new book. So it would, of course, be as cheap to give everyone a new book to keep as it is to lend them an old one and ask for it back! People read more than ever; they just don’t care for or need libraries. It is not just libraries which are in decline. There have been sharp downturns in visitor numbers at traditional art galleries outside London. This is in spite of the national decision to abolish entrance charges. The fall in numbers in 2013, in just one year, was striking even at some of our finest galleries – e.g. the Ashmolean in Oxford down 12%, the Birmingham Museum & Art Gallery down 13%, the Scottish Portrait Gallery down 20% and the Walker Art Gallery in Liverpool down 30%. This has been a clear trend over the last 10 years – whether it’s the new blockbusters like the Royal Armouries in Leeds only getting two-thirds of the visitors it had 10 years ago or the traditional civic museums like the Shipley Gallery in Gateshead where numbers have halved. These trends can be seen in modern media too. Let’s look at TV, which is something that young people have stopped doing. Those aged 16-24 watch less than half as many hours of TV as those aged 55-64, whilst pensioners watch TV for nearly 40% of the time that they are awake. The median age of a BBC1 viewer is 59 (compared to 40 for the population as a whole). But it’s not just that people watch less TV. It’s that they watch much less of what’s been funded by their taxes. Whereas 30 years ago, BBC1 and BBC2 had just over half of the total TV audience, today they have little more than a quarter. But every household is obliged to pay £80 a year just for these 2 channels, whether they want them or not. Meanwhile, BBC TV struggles to look different to its main rivals, comes second in many categories it used to dominate (eg news, sport, music). It’s as similar picture on radio, if you excuse the pun. The majority of listeners under 45 years of age listen to commercial channels and 85% of people never listen to BBC local radio, a service almost exclusively made for pensioners.
The budgets for all these subsidised services (be they libraries, galleries or public service TV) are clearly under pressure, but they are not being fundamentally challenged. When under pressure, these subsidy-junkies quickly ditch their public service mission and play politics. So in spite of its failure to attract young audiences, the BBC is scrapping BBC3, its one TV channel for young people, in order to protect budgets for its oldest audiences. Guess which audience is twice as likely to vote or pressurise politicians? Given that public funding is limited and that out-of-date providers hog our cultural assets, if we’re going to break the current inertia we will need some big, simple bold proposals. Here are 4 from me to stimulate the debate:

(1) Give the 10 million poorest people a Culture Card worth £150 per year and let them make their own choices on what culture they want to access

This is my “prevenge” against the argument that taxpayer-funded universal services are the only want to protect the poorest in society. Given that we can save some £1.5 billion per year from my options below, we can afford to put £150 into the hands of each of the 10m poorest people in society. Lacking the paternalistic gene, I would rather let people spend this as they wish. But I accept that any progress in this area will require a modernised paternalism rather than its abolition. If the £150 is credited to a Culture Card (or account) people can spend this on approved items. There can be lots of debate about what gets approved. But £150 is a meaningful amount of money. It is more than enough for example to buy both a Kindle and a year’s subscription to Kindle Unlimited giving access to 600,000 books. It’s enough to buy 3 theatre tickets. It’s enough to visit a full price art gallery exhibition every month. If allowed, it’s enough to buy a subscription to both Spotify and Netflix.

(2) End public funding for libraries and let people find new solutions

If we just said that by 2016 public funding for libraries was ending, new solutions would emerge. £1 billion would be saved. If not recycled into my Culture Card, this could alternatively provide a 5% cut in council tax or a trebling of the Arts Council budget, depending on your preferences. Only about 10% of library spend goes on books and materials. The biggest cost is staffing. So the first option is for volunteers to step forward. Indeed they have been doing just this since austerity started in 2010 – the number of volunteers has doubled and 1 in 6 libraries are now entirely run by volunteers. The world is full of local volunteers, e.g. the 200,000 volunteers in charity shops. The second biggest cost is the buildings. Very rarely is there a reason anymore to have a dedicated library building. The world is full of under-used buildings – shops, community centres, public sector offices, etc. Given that library catalogues are available online and content is going digital, the opportunity for libraries to co-locate are legion. In this new world, libraries would be free to charge for books and seek philanthropic sponsorship. People might be encouraged to donate their previously read books, recirculating books in the same way that charity shops do right now. With a billion pounds a year of annual savings and lots of capital receipts from buildings, Government could endow a national foundation with the funds to create a national infrastructure to support local libraries – it could hold one big collection (rather than the 200 we have now); it could use Amazon or others to manage storage and distribution; it could digitise books and give access to home downloading; it could create one big website, linked to all the local library charities, or maybe it could just add an item to Amazon’s market place. Or maybe this is all just a new version of an out-of-date service. Do we actually need to bother with physical books at all? It looks as though the market is about to explode with Spotify-for-books solutions (Oyster, Kindle Unlimited, etc) where for a pound or two a week readers will have unlimited access to e-books. Maybe we should just close libraries and rely on the Culture Card and the online book services? /p>

(3) End the BBC Licence Fee, sell-off the BBC and let it thrive

Ending the BBC’s licence fee is (and is intended to be) an act of kindness, not cruelty. I think it will thrive and grown in a market where it has to earn its revenue from the free-choice of consumers. Conversely, I think it will die a long and horrible death if it stays licence funded, where under pressure from a declining revenue it retreats to a more and more conservative offer to its core, older audience to muster their political support. In its propaganda for keeping the licence fee, the BBC routinely cites market research showing that the public is willing to pay more than the £145 for its services. In which case, why compel them (under threat of criminal conviction and time in prison) to pay for it? Let’s assume that the BBC stayed advert-free and look at some examples. It’s hard to imagine BBC Radio 5’s 7m listeners would be unwilling to pay £11 per year to cover its existing costs. I, and most listeners, would certainly be willing to pay several times more. I would be pleased to save the £10 per year needed for Radio 4 (which I am coming to loathe) but I’m sure most of the 11m listeners would be willing to pay several times more than £10. I’d probably subscribe to the £100 per year needed for BBC TV, but if a lot opted out I look forward to being heavily wooed with new exciting content to go as far as £200 per year. But then many parents with young children would probably pay that just for CBBC and CBeebies. These few examples preview a new world if which both popular and niche services thrive and expand in response to customer demand. In terms of practicalities, payment for digital TV and online content are already well established. The BBC would need to find a way to paywall radio, but I am sure that’s not beyond them. As a country we could sell-off the BBC, perhaps as a number of different companies to encourage diversity and competition. Let’s assume that generated a£10 billion receipt. This could fund a new “British Production Trust”, which like the Wellcome Trust for science invests its endowment in the capital markets to generate an annual income to pay for good works. The “BPT” would finance (and co-finance) high quality, innovative or niche content to fill gaps in the commercial market. With a £10 billion endowment and assuming a commercial return on a third of its projects, it could probably afford £500m each year – equal to the current budget for BBC2 or the national BBC radio channels.

(4) Empty our art galleries of their collections, fill them with working artists and get the old artworks into new everyday settings

There are 210,000 oil paintings in public collections in the UK. Visiting them all would require you to get around 3,200 different collections. Most people just visit their local collections. But once they’ve been once or twice they’ve seen them and the incentive to return is limited. But even if you managed to visit all 3,200 collections (a feat which assuming one visit per week would take 60 years of dedication) you would only see one-fifth of the 210,000 paintings. Only 20% of the paintings are on display to the public. The other 170,000 paintings are in storage. My proposal is that all 210,000 paintings should be available on request for public display in the everyday places where the public goes about its normal business. They could be lent out to any one with a public or semi-public space – in offices and workplaces, in supermarkets, in schools, in airports, in churches, in restaurants, in colleges, in shopping malls, in leisure centres, etc. Most of these buildings have just as much as security and climate control as galleries and archives. One way or another public funding has bought or maintained these collections, so the public should get to look at them, in the places they visit. It would be great to think of Tesco curating inspired exhibitions or a primary school using a term with 3 Pre-Raphaelite paintings as the basis of a history project on life before Raphael, in his time and during the revival of the style which predated him. The marvellous Public Catalogue Foundation has digitally catalogued all 210,000 of these paintings, so the lending can begin. Emptied of their collections, our galleries could be filled with the studios and exhibitions of working artists. There could be high profile competitions to win a year’s placement in the gallery, letting the public see artists at work and giving them the chance to buy the art produced. Rather than paying a bored security guard in a gallery to watch almost nobody visit some dull Victorian paintings, why not use those salaries to create a bursaries for each artist during their stay in the gallery? Imagine school visits to these working artists inspiring a next generation of youngsters to want to produce their own work, rather than boring the pants off them touring the hallowed galleries of yesterday’s fashions. Clearly there are a few national galleries in London where the sheer numbers of tourists mean that the same old collection is constantly fresh to large numbers of visitors. They might stick with the old model, but introduce entrance charges instead of taxpayer-funded free entrance. Most visitors expect charges, which they pay in other capital cities.

These are just 4 ideas we could unleash if we’re brave enough to break the inertia in our publicly funded arts and move on. There are lots more. For example, as cinemas move from celluloid to digital in the next few years, imagine if they could be convinced (or received a little public funding) to give open access to half their screens on the quiet nights (Monday to Thursday) allowing young kids to put on cinema showing of homemade movies for their social networks? The extra sales of popcorn alone would probably pay for any costs. But before the new comes the end of the old and to inspire the public we must be bold.

A simple idea to end poverty for millions of households overnight – at no cost

I have a simple proposal which could end poverty overnight for millions of British people. It doesn’t cost a penny – quite the opposite. It would save the government billions of pounds every year. It would make the UK a much fairer society. So, what’s the catch? Well, this ingenious way of making the UK a fairer place may itself be considered just too unfair by the wider majority of people. The only barrier to my proposal is the potential resentment of the majority to a minority (i.e. the poor) getting something special. To be politically feasible it would need a Grand Alliance of right-wingers and the left-wingers to overcome the centrist moderates. I’m not saying that centrists are against ending poverty. Usually they are reasonably supportive – so long as it doesn’t require too much effort or imagination. But they don’t like only the poor getting something for nothing – especially if it’s a really big something. And in my proposal the poor would certainly get a pretty big something.

Before I set out my proposal, let’s look at the potential for a Grand Alliance of right-wingers and left-wingers. When it comes to policy ideas to address poverty, what is each group currently looking for? The right-wingers want three things: to make big cuts in welfare spending;to find an iconic neo-Thatcherite policy which has a chance of turning the poor into conservatives; to reverse the sharp decline in the proportion of people who own their own home. The left-wingers want three very different things: to protect the poor from austerity; to help working people on low wages with the cost of living; to find a new way to redistribute wealth without frightening away middle class voters by putting up taxes or increasing welfare spend. Luckily, my proposal ticks all six of these boxes!

So what is this proposal? It is to transfer ownership of the 4.1 million social homes in England (one-fifth of the total homes in the country) to the tenants who live in them. (If the other UK countries did this too, more than 5m social homes would be given away across the UK). This is not Right to Buy. The tenants would get the houses without paying a penny for them. On average these homes are worth about £120,000 (ranging from £80,000 in the North to £150,000 in the South East and up to £250,000 in London). The 4m English tenants would get control of £500 billion of public assets and they would no longer have to pay the £20 billion per year of current rent. The average rent is £85 per week (ranging from £60 in the North to £100 in London). As £12 billion (two-thirds) of this rent is paid by the Government through Housing Benefit, the Government would be £12 billion per year better-off if it no longer had rents to support. This all works because the average £120,000 social home only has £18,000 of outstanding debt, leaving equity of over £100,000 for someone to enjoy. And in this proposal, it is the tenant who gets to enjoy it. But who would pay-off the £18,000 of debt for each house, equal to £75 billion across the 4m homes?. My proposal deals with this. When the homes are transferred to the tenant, the Government would retain a 20% charge (a lien) on the property which it recoups when the tenant finally sells the home. This is enough (at £24,000) to pay-off the current debt and the interest payments which would otherwise accrue between now and the sale of the home. The Government would immediately sell-off these charges (or liens), raising £100 billion in cash. With this it would pay-off the current debts. Many of these 20% stakes in the former social homes could be sold to retail investors, giving the middle class the opportunity to invest in property for £24,000 a go. It would be a low risk investment (as it would be the first charge on the property so the value of the investment is protected so long as the home doesn’t fall below 20% of its current value; in all likelihood house prices will rise, even if only modestly, increasing the value of the 20% stake). In future, those in severe housing need would have to exclusively find homes in the private market with Housing Benefit helping with their rents, as it does with millions of poor private sector tenants today. To recap, the tenants would immediately own 80% of the property. And there would be no rent to pay. Now, let’s look at the 4m tenants who would benefit (or the 5m if the rest of the UK copied this approach).

One-third are pensioners, one-third are in work and one-third are out-of-work. My proposal would mean that more than 1.25m pensioners became home-owners. They might decide to sell the home and take the average £100,000 of wealth and move to a smaller property or to join their family. They would have wealth which could be inherited by their family. This matters, as one of the key drivers of inter-generational poverty is the lack of assets and wealth to transfer to children and grandchildren. Although 70% of pensioner tenants are getting their rent paid by Housing Benefit, there are 350,000 who fully pay their rent themselves and they would be £85 per week better-off. To put that in perspective, the State Pension is only £113 per week. In addition, there are a further 300,000 who only get partial Housing Benefit and therefore pay part of their rent. So that’s 650,000 pensioners who would be substantially better-off each week, as well as being part of the 1.25m new OAP home-owners with £100,000 of equity.

Now, let’s look at the third of social tenants in work – that’s 1.55m tenants. 80% of this group earn less than £25,000 per annum, i.e. they earn less than the average income. The other 20% earn above £25,000, but mostly not much more than that. Most of the tenants (three-quarters) in work pay their own rent – so 1.2m of them would, on average, be £85 per week better-off. For someone earning £18,000 per year that’s equivalent to a 30% increase in their wages. Again many of those in work who do get Housing Benefit only get part of their rent covered so a couple of hundred thousand more people in work would be tens of pounds per week better-off. And both groups in-work would have £100,000 in equity in their home, on average. One option available to them would be to use this equity to trade-up and/or relocate to another private home. They would have entered the same free world as other home-owners.

Finally, let’s look at the third of working age tenants who are not in work. This group broadly falls into two halves. The first half is the 850,000 tenants who are affected by illness or disability. This includes those who are long-term ill or disabled (700,000), temporarily ill or disabled (50,000) or carers for their own family (100,000). 90% of this group receive housing benefit. Whilst a minority of this group can and should return to work, most of the group will remain economically inactive. This proposal would mean that some 200,000 of them (i.e. those not receiving Housing Benefit at all) will no longer have to pay rent and a further group will no longer have to make partial payment. The second group are those who are able-bodied and in good health but not working. This group of 600,000 tenants, includes 450,000 who are unemployed and 150,000 who are inactive lone parents. About a third of this group pay all their own rent. When we step back and look at the 850,000 tenants who are not working but could, we can see that the big advantage of this proposal for them is that it greatly increases the incentive to work. At present (and even under Universal Credit), if an out-of-work social tenant on housing benefit takes a job then 70% of the extra income is clawed back, as the Government reduces housing benefit support. Losing housing benefit is a big disincentive to returning to work. For single people, for example, it is likely that the social rent of £85 per week is a bigger part of their welfare support than their unemployment benefit of £72. The beauty of my proposal is that there is no rent, so there is no housing benefit and therefore there is nothing to lose in returning to work. This kills dead the 70% marginal tax rate (from the Housing Benefit withdrawal taper) on those returning to work. This is also true for those already in work receiving Housing Benefit. At the moment, if they find a higher paid job or increase the number of hours they work each week, they are penalised by 70% of the increased wages being cancelled out by lost housing benefit.

Essentially this is a simple proposal – give away the homes, clear £75 billion of debt, relieve tenants of their rents and save billions per year in benefits. There are a number of big practical things to think about. Firstly, the downside for the new homeowners is that they have to pay for their own repairs and maintenance. It is worth noting that many existing owner occupiers have low incomes – for example, even in London 40% of the poorest households (the bottom quartile) are owner-occupiers. And these millions of poorer people cope with owner occupation. For the 56% of social tenants who currently pay full or partial rent, they can use the money they save on rent to fund repairs. For many of the other 44%, the responsibility to pay for repairs will incentivise them to find the money, e.g. many pensioners will get help from their families; many who are out of work will aim to earn money to fix the home they own; many may take advantage of the freedom of being the owner to take-in in a lodger to increase their income. But for those who feel unable to cope with the liabilities, we could let them decide to continue being a tenant. Secondly, there will be those who worry that the new home owners will sell the house quickly, squander the proceeds of the sale and turn-up as a homeless case a year or two later, requiring the State to find them a home and pay the rent. If people are seriously worried about this risk, we could solve it. One way to do this would be to give the new home-owners 70% of the home value when it is sold and retain the other 10% (£12,000) for 3 or 5 years. This could be called a Welfare Bond. If the former tenant requests housing help (housing benefit or social housing) within the, say, 5 year period then he or she would forfeit the £12,000. If there are no claims in the 5 year period, then the former tenant gets a cheque for £12,000. That’s a big incentive not to go onto benefit or blow the money. Thirdly, this would all require a major piece of primary legislation as it would affect not only councils but also housing associations. It would also require Government to put in place the financial machinery to allow it all to happen smoothly (e.g. pooling receipts and debts across the country and cash-flowing the changes). But these practical things are all soluble if politicians want to drive through this proposal.

So if this is all feasible, is it desirable? The biggest challenge is resentment, especially from those renting in the private sector and those on modest incomes who have paid / are paying for their own house through monthly mortgage payments. Why should those who happen to live in social homes get such generosity? There is no easy answer to this. I could just say “people sometimes get lucky” (e.g. inheritance windfalls) or “wouldn’t it be great to give these millions of people a break?”. Or I could say “if you leave them as social homes, no one will access the £100,000 of wealth in of them or save any money” or “the people in the social homes hardly ever move out, with just 5% of properties churning each year, so we may as well just give it to them”. But I suspect that not enough people share the generosity underpinning my proposal. Nor would it win-over everyone if we explained that our society would be better – 4m poor people would have meaningful wealth; we would have the highest level of home ownership in the G7; we would have greater social and residential mobility; etc. So let’s think of what’s in it for the 80% of the British public who don’t currently live in social housing. One option would be to take the £12 billion of annual savings on housing benefit (described above) and explicitly use it for something else. For example, it is enough to virtually double public spending on adult social care. Or £12 billion would be enough to abolish taxes on the middle class – e.g. £12 billion is enough to cancel inheritance tax and stamp duty on housing sales. Or if we’re still focused on poverty, £12 billion is about enough to remove everyone on the Minimum Wage from paying tax. Or it could be used to build more shared ownership homes for first time buyers, allowing some 200,000 extra homes per year to be built. This would get the building of affordable homes back to the levels of the 1950s and 1960s. After 10 years, 2m new homes would have been built. (Alternatively, for those who believe that we need traditional social housing this could be 200,000 social homes being built each year. This is enough to replace the 4m homes sold-off over a 20 year period. In fact, only 200,000 (5%) social homes currently become vacant each year. So if we did this no-one would notice that the 4m homes had been sold-off in terms of having new, and better, ones available when they are needed.)

I return to the need for a Grand Alliance of Left and Right to face down the Moderates – partly to deal with the resentment, but also because Moderates don’t like radical changes of this magnitude. I would say to both left-wingers and right-wingers, it’s not often that any politicians get the chance to do something dramatic to sort out poverty overnight, especially in a way that costs the tax-payer a lot less. Given that both Left and Right can win from this proposal, they only lose by doing nothing, leaving all that money tied-up in the 4m homes, the poor still poor and the welfare bill climbing every year. So why not do it? Unless, either of them has got a better idea?

Israel – A “Hard Shell, Soft Centre” Solution?

The other day, after some of the worst news yet from Gaza, I overheard an English woman say “Why can’t the Arabs and Jews just stop this dreadful killing and learn to live together?”. Her companion rolled her eyes, shook her head and snapped “Dream on…” The first woman gave a sheepish grimace, clearly humiliated by her apparently banal suggestion. And yet living together (fairly) happily is what 1.7m Arabs do everyday within Israel. These are the Israeli Arabs who make up a fifth of Israel’s citizens. There are nearly twice as many Arabs living in Israel now as there were in 1947 before modern Israel was established. There are more Israeli Arabs than there are Gazan Arabs. One of the most interesting, if inevitably controversial, voices to emerge from Israel in recent years is Ishmael Khaldi, who in “A Shepherd’s Journey” tells of his rise from a poor Bedouin family in Galilee to become a prominent Israeli diplomat. Like many Bedouin of his generation in his youth he volunteered for the Israeli army. In 2009, Khaldi caused a stir when he said “By any yardstick – educational opportunity, economic development, women and gay rights, freedom of speech and assembly, legislative representation – Israel’s minorities fare far better than in any other country in the Middle East”. Khaldi is forceful on the need for Israeli minorities to have much stronger rights. But his sentiment is similar to that of one of the most prominent Israeli Arab journalists, Khaled Abu Toameh, who in 2009 said “Israel is a wonderful place to live and we are happy to be there. Israel is a free and open country. If I were given a choice, I would rather live in Israel as a second class citizen than as first class citizen in Cairo, Gaza, Amman or Ramallah”. Three-quarters of Israeli Arabs identify as Israeli and less than a quarter say they would be willing to move to a Palestinian state. Indeed, when Israel recently proposed transferring the Triangle Area (home to 300,000 Israeli Arabs since 1949) to the Palestinian Authority in exchange for settlements in the West Bank, there was overwhelming resistance from Israeli Arabs. Whilst in law, Israeli Arabs and Jews have equal rights, in practice there is significant discrimination against the Arabs. This is a mix of budgetary discrimination (e.g. Arab schools receive much less funding), unfair access to land (n.b. the Israeli state controls 93% of land and is not even handed) and asymmetric immigration rights (i.e. any Jew anywhere in the world can immigrate, whereas Palestinians abroad have extremely limited rights of return). Because Israeli Arabs are, mostly, exempt from conscription, they do not enjoy the substantial rewards (e.g. scholarships and housing loans) on offer to those who complete military service. However, the Druze, who form 10% of the Arab population, are an exception. They play a distinct role in Israel, being subject to military conscription, having substantial autonomy in running their won affairs and achieving high profile success in the army and in government. Another minority is the 10% of Arabs in Israel who are Christian, who are distinguished by success in education. However, the 80% of Israeli Arabs who are Muslim do less well than Jews on most measures. Their poverty levels are similar to the Ultra-Orthodox Jews. Some of the reasons for the relative poverty are similar to the Ultra-Orthodox -e.g. a low proportion of women working and large families. But it is important to remember why Israeli Arabs want to stay Israeli. And why 85% of them believe in Israel’s right to exist as an independent state. Compared to other Arab countries, Israel offers its Arabs higher incomes, utilities that work, democracy, stability, freedom from corruption and better access to welfare services. Just one fact amongst many that tells the story – Israeli GDP per capita is more than $36,000, compared to the West Bank & Gaza with less than $3,000 per capita. Israeli Arabs live on the side which is twelve times richer. But particularly since the Arab riots of 2000 in the Second Intifada, the Jewish population is frequently wary of its Arab citizens, fearing betrayal and entrenching segregation. The current conflict in Gaza is inflaming these fears and reinforcing dividing lines. Loyalties are polarised. As Abed al-Aziz Zoabi (the first Arab to serve as an Israeli deputy cabinet minister), famously said in 2000 during the Second Intifada “My country is at war with my people”.

My reason for reminding you that one-fifth of Israelis are Arabs? Because the most pressing issue is to decide whether a One State Solution can work for Israel – one which stretches from the Mediterranean Sea to the Jordan River, a country in which the Jews retain a majority but a much smaller majority. Until recently, this One State proposal has been largely associated with the extreme right-wing in Israel, based on simply annexing the Palestinian territories and facing down world-wide protests. Instead for the last 40 years, the Western led peace process has been based on a two-state solution – with separate nations for the Palestinians and Israelis, living as friendly and respectful neighbours. However, this solution is clearly not going to happen. Continuing to pretend that it is a feasible solution fuels the ongoing conflict in the region and excuses the dreadful progress in improving the lives and prospects of Palestinians. The last 40 years of the peace process has been like an endless and painful pregnancy, expected to deliver the twin babies of the two states – with all those echoes of Abraham and Sarah for both Jews and Muslims. But no successful pregnancy goes on indefinitely. If the peace process was subject to a scan, it would reveal that if there are still any live twins in the belly of the peace process they are at best Siamese. But instead, I think a honest scan would show that the second, smaller twin has either died or would not survive. To put it starkly, the West should accept that the Oslo Accords have gone the same way as Monty Python’s Norwegian Blue.

Any search for a solution needs to set aside the desire for historical justice, on either side. Both sides have suffered badly in the last 80 years, both within Israel / Palestine and internationally. There is no solution which can mutually satisfy the full yearning for historical justice. Nor is there any solution which gives each side a future free of the other. Both sides are there to stay and their future security and prosperity are inseparable. Finding the least worst option for both sides requires three bold steps. The first step is the Palestinians embracing Israel’s right to exist and its need to defend itself vigorously against its enemies. The second step is the Jews embracing the absolute entitlement of Palestinian Arabs to equal civil rights and shared prosperity. The third step is committing to a One State Solution which gives Israel the national security it needs and the Palestinians the civil rights and prosperity they deserve.

Given the balance of power, it is for the Israelis to take the lead on proposing a new solution. I think they could devise a “Hard Shell, Soft Centre” solution, which passes two tests:

(a) The first test is that a viable solution has to offer Israel the greatest guarantee of national security – in the eyes of the Israelis. That is a high bar. If a proposed solution doesn’t pass this test, there will be no sustainable progress. Israel will not play. It has shown that it cannot be made to play. Any progress, therefore, requires Israel being made (and perceiving that it is being made) as strong in the region as possible. This precondition may be unacceptable in principle to many in the region and around the world. But in practice it cannot be avoided. I don’t see how Palestinian independence (however attractive it is for other reasons) can pass this test. Israel will not tolerate the security threat of a weak and unstable Palestinian nation on its doorstep. It will want to vigorously control the security of the second state. It has bitterly regretted losing control of the Egyptian border with Gaza after it withdrew its military and settlers. It continues to tighten its grip on the West Bank and hasn’t been afraid to militarily intervene in neighbouring independent states like Lebanon to aggressively tackle security threats. There is little point in liberal protests that Israel should keep its nose out of the Palestinian areas. It won’t. And to be fair to the Israelis, their region is full of threat and uncertainty. Let’s remember that 32 nations don’t recognise Israel’s right to exist, that Israel has experienced full on wars with its neighbours and the threats of annihilation from Iran still echo around the region. And the level of regional uncertainty is getting worse everyday. This is a region in which nation states are collapsing – just look at the recent demise of Syria, Iraq and Libya. It is a region where the demographics of countries can change entirely almost overnight due to the movement of millions of refugees – e.g. Lebanon and Jordan are unrecognisable demographically from two years ago. And it is a region in which weak countries, as Palestine would inevitably be, suffer endemically from proxy wars between the richer or more powerful nations, e.g. the sponsorship of Hamas and Hezbollah. So, it is inevitable that Israel will insist on total security control of any Palestinian state and, more likely, it will prevent the birth of any such state and the risks it perceives it will bring. Therefore, a meaningful Two State solution has no foreseeable future. In terms of the options to maximise Israeli security, real and perceived, one that is often discussed is the Three State solution, in which the West Bank returns to Jordan and Gaza returns to Egypt. That is essentially the 1947 split of Palestine which lasted until the 1967 War. There have been times when such a solution would have looked attractive to Israel, when both Jordan and Egypt have been strong and respected neighbours. But, the point is that there have been times when this has not been true, e.g. when Hamas’ ally the Muslim Brotherhood was elected into power in Egypt in 2011. Whilst Egypt could absorb Gaza (and control of Gaza would help it tackle extremism in Sinai), it far from clear that Jordan could (or would be prepared to) take on the West Bank. There are of course 500,000 Jewish residents in the West Bank who are unlikely to want to become Jordanian. Even if those countries wanted to take back the Palestinian areas, it is hard to believe that Israel would feel at peace with two potentially hostile countries close up to their major urban areas, as they were in 1967. The One State Solution would mean that Israel could extend and deepen its security control to the external borders of the Palestinian territories. This would give it a Hard Shell. The major security question would be whether with One State from the River to the Sea it could secure internal control within those territories, which brings us to the next test.

(b) The second test is finding the solution which would maximise the civil rights and prosperity of the Palestinians. This would give the “Soft Centre”. Recently, Tareq Abbas (the 47 year old son of Mahmoud Abbas, head of the Palestinian Authority) declared himself in favour of the One State Solution, stating to Israel: “If you don’t want to give me independence, at least give me civil rights. That’s an easier way, a peaceful way… I don’t want to hate anybody. I don’t want to shoot anybody. I want to be under the law”. His 79 year old father acknowledged that support for the Two State solution is dominated by older Palestinians. Polling shows that whilst two-thirds of those over 50 support a Two State solution, less than half of 18-34 year olds support it. In exchange for the strengthening of its security in a One State Solution, Israel needs to respond with the maximum offer of civil rights and prosperity for the Palestinians. Creating One State will boost prosperity through removing internal restrictions. The World Bank has shown that Israeli restrictions reduce the West Bank’s GDP by 35%. The blockade of Gaza has crippled the country’s economy, where four out of five Gazans depend on foreign aid. But sharing prosperity will also cost Israel money – a lot of money. There is a massive need for investment in infrastructure and education. For example, Israel has nearly 1,000 kilometres of railways. The Palestinians have none. Palestine has already had far more aid than the Marshall Plan gave to Europe. But any political settlement must include a clear and massive investment plan, with an equal commitment of Israeli and international funding. In the context of One State, the granting of most civil rights (freedom of expression, freedom of internal movement, equitable funding in education, equal access to land and building permits, etc) should be straightforward and immediate. Israel should have to put these equal rights into its Base Law. There are a variety of options about military conscription (e.g. continuing the exemption of Israeli Arabs or extending the community based agreement to conscription of the Druze). The most difficult issues will be those which undermine Israel’s ability to remain a Jewish state, whilst being a democracy. That comes down to demography. Whilst polling amongst Israeli Arabs has shown that three-quarters would accept “A Jewish democratic state with equal rights for all minorities”, this is clearly much less attractive to the Palestinians. For a long time Israelis rejected a One State solution because of fears of the “demographic time bomb”, in which Arab population growth was outstripping that of the Jews. But those trends have turned. Fertility rates are now similar and migration has favoured the Jews. There is much dispute about the actual population of the Palestinian territories. But if we accept the official figures, a One State solution would increase Israel’s population from 7.8m to 12.1m, with the Arab percentage rising from 20% to 45%. (If just the West Bank joined Israel the figures would be 10.5m and 37%). A lot of the political issues could be addressed by decentralising power within the country, given that populations (even within the current Israel) are highly segregated. But at a national level, Israel would face the choice of either staying a Jewish country or becoming secular and multi-cultural. Ideally, the Greater Israel could be a regional beacon of a multi-cultural, liberal and secular democracy. That should be the ask of the international community. But I suspect that Israel is not going to accept that in the foreseeable future. So we need to find a less than ideal solution. Israel could protect, or even extend, the Jewish majority (as it does now) by controls on immigration, with discrimination in favour of Jewish immigrants. This would be highly offensive to the Arabs, but no worse than the status quo. It could also vary the electoral franchise to manipulate a Jewish majority, e.g. with differential voting ages. Again, this offends all our liberal sensibilities. But compare it to what is happening in the murderous chaos across the region and more particularly within Israel / Palestine and ask if it is a price worth paying?

The worst thing about the current troubles in Israel / Palestine is the sense that there is no better future on offer, just a state of permanent war and an international community unable to accept the death of its preferred option of Two States. Instead this “Hard Shell, Soft Centre” strategy offers Israel much greater control of its security in exchange for offering near-equality to the Palestinians. It accepts the power which the Israelis insist on having over the Palestinians, but in exchange it requires them to take responsibility too. It is far from perfect as an option and will be offensive to many on both sides. But with the Middle East imploding, a new future has to be found – not just for those living in Israel and Palestine but to inspire people across the region that liberal multicultural democracies are the route to peace and prosperity. Thinking of another time when necessity required action not perfection, I am reminded of Sir Robert Watson-Watt, whose invention of radar turned the tide in Britain’s fight agains the Luftwaffe in the Second World War. Watson-Watt fought for the “cult of the imperfect” and famously told the Government to get on with his solution – “Give them third best to go on with; the second best comes too late; the best never comes”.

What Nigel Farrage has got right … and the need for radical political reform

“He operates in the gulf between the public and us here at Westminster. And there’s plenty of room for him there.” For most people in the UK there is no need to explain who is being described here. For any foreign readers, it is a quote about Nigel Farrage, leader of the UK Independence Party (and it was said by one of the UK’s most distinguished Parliamentarians, Frank Field). However, if the word “Westminster” was replaced with “Washington DC”, or “Brussels”, or “Paris” etc, then it could easily refer to any of a growing number of anti-establishment parties – the US Tea Party, the French Front National, the Spanish Podemos or the Greek Syriza. There is clearly a crisis in democracy in the West. Gallup’s global polling shows that in much of the West the majority of the public has lost confidence in their form of national government. This is at its most dramatic in the Mediterranean countries, e.g. in Spain where confidence has fallen from 58% in 2008 to 18% in 2013, although this still puts it ahead of Italy, Greece and Portugal! National government in these 4 countries enjoys lower public confidence than in the Democratic Republic of the Congo! Whilst confidence remains high in some Nordic countries (e.g. Norway at 66%) and above 50% in several other western countries like Canada and New Zealand, it is also very optimistic in many developing countries such as Ethiopia (77%), Ecuador (62%) and India (56%). But the majority of  British people lack confidence in national government (just 38% are confident), a similar level to the French, Danish and Japanese. It’s better than in the US (29%) but well behind Afghanistan (48%)! Indeed, 4 out of 10 British people lack confidence even in the honesty of national elections, albeit that’s better than in the US where it is 6 out of 10. In the UK, public satisfaction with the leaders of the 3 main political parties has reached a historic low, with the combined scores of all 3 being -22%. One of the most striking manifestations of public alienation is voters staying away from the ballot box. For comparison it’s worth noting that the X Factor Final typically sees 1 in 4 of the public voting for their choice. The recent European elections saw just 1 in 3 UK adults voting – a similar level to that achieved in recent local government elections. Turnout is much higher at the General Election, but in the last decade only 60-65% of adults have bothered to vote even at this level, compared to say the 1950s when up to 85% would vote. The two most popular UK politicians are Nigel Farrage (who is anti the political elite) and Boris Johnson (who looks like the elite, but is directly elected as Mayor of London). We should look for clues in their popularity.
However, these issues of alienation run deeper than politicians would like to believe. It’s not just nihilistic cynicism, recession fatigue or unpleasant racism – although there are elements of all of those. It seems that people are concluding that, for all the promise of democracy, ordinary people appear to have little or no impact on their Governments. We now know this is true – at least in the US, for which we have data. Earlier this year, Professor Martin Gilens of Princeton University published very powerful research which showed that “ordinary citizens have almost no influence over what their government does in the United States”. Gilens had looked at the history of almost 2,000 policy decisions over a 20 year period. He found that the economic elite ( corporations, business and the richest 10% of people) got their way two-thirds of the time, twice as often as the median citizen and sixty times more often than the bottom 10%. This mattered most when people at the top and the middle disagreed – e.g. over tax levels and the regulation of business. Guess what? The people in the middle tend to lose the argument. Even when there was 80% or greater support in the country for a particular policy change, the change mostly didn’t happen. That was because policy debates were heavily influenced by interest groups. Interest groups were dominated by the economic elite (e.g. business and professional associations). In the US, the preferences of business interest groups negatively correlated with the majority preferences of the US public. Business interest groups were twice as influential as mass interest groups – mainly because they were twice as active. And interest groups (the research shows) were mostly against change. The elite preferred things as they are – by definition, it seemed to work for them! So the lack of majority power and a status quo bias meant that even when large majorities wanted change, they often didn’t get it, unless the economic elite wanted it too. I haven’t seen similar research for the UK, but I suspect it would make uncomfortable reading for most politicians, probably with the exception of Nigel Farrage, who might suddenly have an evidence base for his anti-elitist rhetoric.

So, if these are deep problems, what could be done? The political class needs to have a radical think about constitutional reform. Now, I have catholic tastes in my existing friendships across the political class. Some are passionate about equality, others about free enterprise; some have invested their lives in global development, others in parochial pavement politics. But I must admit I have always crossed the road to avoid constitutional reformers – those whose lives are devoted to voting systems and political structures. The constitutionalists always remind me of those hi-fi buffs who obsess over expensive and obscure woofers and tweeters, but then turn out to like nothing more than Simon and Garfunkel or Celine Dion! Like many, I have rather lazily assumed that the British don’t really go for constitutional change. Like many, I have a vague sense that our constitution has organically grown over centuries to give us a stable, if occasionally eccentric, system. But, of course, much of this history is pretty recent. A hundred years ago on the eve of the First World War, 16 out of 20 people didn’t even have a vote. The last thirty years have in fact been a period of hyper-active, if completely incoherent, constitutional reform. We have had: devolution to Scotland and Wales; self-government in Northern Ireland; proportional representation in local government in Scotland and London; the abolition of metropolitan government in our major cities; the creation of Select Committees; and, the widespread elimination of county government. In just the last couple of years, we’ve had referenda on an Alternative Voting System and Elected City Mayors, along with another intense, but failed battle to reform the House of Lords. This year we have a referendum on Scotland leaving the UK and within 3 years we’re likely to be voting on whether to remain in the European Union. So clearly the British do do constitutional reform! However, it’s all one sort of democracy. Whether it’s devolved, national or international, our ability to influence things comes (for most people and most types of voting) through parliamentary style representation. By and large, our democracy is representative – we choose someone to represent us in a council, a national parliament or an international parliament and then they go on to join-up with others and choose their leaders, who in turn become our leaders. So, we have, mostly, an indirect democracy. And where we don’t have proportional representation, then the first past the post system means that voters in safe seats have little individual influence on the national system. My eldest (and politically active) daughter who gets her first General Election vote in 2015 has realised that living in the Henley-on-Thames constituency removes her right to have any impact on whether Ed Miliband becomes Prime Minister. But even if she had a way to help him into office, he could easily be replaced by his party colleagues without reference back to the electorate. Given the limitations of the national voting system, what about all the other votes that express the people’s will? Everyone has at least 3 votes – local, UK and European. Some have 4 (e.g. in Scotland or London) or even 5 votes (e.g. in shire county areas, with county, district and parish). But with the exception of the devolved administrations (like Scotland or London), the other votes (local government and European) too often tend to be poorly attended protest votes against the national government of the day, rather than real votes about local or European issues. I have mixed feelings about my inability to name the leaders of either the county or district council leaders where I live. On the one hand, it’s embarrassing as I take much more interest in politics and government than most. On the other, it’s reassuring that I am part of the 92% majority of people who can’t name their council leaders. The majority of people with an Elected Mayor do know who runs their area – i.e. they have a direct democracy. ( Given my political anorak habits, I can actually name many of the Elected Mayors up and down the country!)

If we are to re-engage the public, we need to offer some radical solutions. In order to stimulate this debate, here are 4 straw men. I am not arguing for them, just arguing that we need to start arguing:

1) Public Juries

A first step could be to give ordinary people a chance to take part in government. There are many decisions which politicians have decided to give away to independent panels, experts and committees. There are national structures (e.g. Low Pay Commission to decide on the Minimum Wage level) and local structures (e.g.panels to decide on the adoption of children). These processes are typically populated by the great, the good and the worthy – the elite. One way to reinvigorate democracy would be to abolish this remote and elitist approach and replace it with “Public Juries”. Members of the public would chosen to serve on these juries, based on a representative demographic sample. Those chosen would be obliged to serve, just as they are obliged to do jury duty in the legal system. There would be a judicial style process chaired by an impartial public servant and the jury would hear arguments from a variety of sources before making a decision. This is not about consultation – it is about replacing the “quango-cracy” or “magistracy” with other decision-making bodies. The jury decision would have the same status as the decisions made by the body which the jury had replaced – i.e. it might be the final decision, or the formal recommendation to Ministers. Bodies which could be replaced by this approach include: determination of the National Minimum Wage level by the Low Pay Commission; the setting of interest rates by the Monetary Policy Committee; decisions by NICE on which treatments should be funded by the NHS; recommendations by the Migration Advisory Committee on immigration levels; recommendations by the Advisory Council on the Misuse of Drugs; recommendations by the Honours Committees on who should get knighthoods and medals; local decisions by Licensing Panels about the sale of alcohol or the numbers of taxis; decisions by economic regulators about consumer prices versus investment in particular regulated industries, such as water; etc. In addition, this approach could be used for a wide range of difficult decisions taken by Ministers, where it is tempting for Ministers to avoid hard choices, e.g. local health service rationalisation plans. Juries might also replace various appeals processes (e.g. for planning applications or immigration). And public juries would offer a better solution than peer review for judging the behaviour of politicians themselves (e.g. on expenses issues). Some of the juries might be small (e.g. for an adoption) or large enough to be nationally representative (e.g. on the Minimum Wage). But (I hear some people say) how can the ignorant masses decide on these highly expert and sensitive topics? Well, the jury approach (trial by one’s peers) works well in our justice system. And most of these decisions are about justice, making trade-off decisions and giving each side a fair hearing. I am envisaging that, as in a trial, there is a moderated opportunity to hear both sides of a case before making a decision. Where Public Juries have been used ( in diverse locations from China to Texas, and on diverse topics from health reorganisation to clean energy) the public changed their minds substantially as they heard the evidence and engaged in the debate. In these debates, it is the role of experts to make their arguments and it is for the people to make the decisions. Participative democracy like this could re-engage the public. It would be possible to allow the public to follow the case (online or on TV). If future decisions are well publicised, there could be a big build up in the public domain, e.g. social media campaigns. And if all this sounds a bit exotic, it’s worth remembering that this was the form of democracy favoured by Aristotle. The Kleroterion was a Greek lottery machine which randomly selected citizens to join a Council to govern Athens. The idea was to avoid the oligarchy of a political elite. It seems unlikely that Nigel Farrage will mention Aristotle (unlike perhaps Boris Johnson) but they seem to be on the same lines.

2) Directly elected European President

A second step might be in Europe. Even the most passionate Europhiles must despair about the democratic mess which is the European Union. There are European elections. But they are for the bit of the European government which has the least power – its Parliament. Day to day power rests with the European Commission which is run by ex-politicians, who are are appointed through the patronage of individual national governments. The big decisions sit with the Council of Ministers, the 28 heads of government who horse-trade their way to compromises which leave none of them satisfied, and none of them feeling accountable to the public. (I gave up trying to explain all this to my newly-voting daughter, who concluded that a UK vote was just about who should get a domestic bloody nose from the voters.) Let’s assume for a minute that we’re staying in the European Union. Let’s also assume that the Council of Ministers reach a fresh agreement on what scope and powers the EU should have (e.g. its role in agriculture or immigration). With these settled, we could then replace the Parliament and the Commission with a directly-elected President. The European public (not the dining rooms of Brussels) would choose their President, using a similar voting system to the French Presidential elections, but with elections held every 3 years. The President would then choose his or her own Commissioners. The Council of Ministers could change the scope or powers of the President and would set the overall budget. But after that, the President would be directly accountable only to the people. He or she would have the option to hold electronic referenda on big issues, or to appoint Public Juries. Assuming that the EU continues, there are huge and urgent Europe-wide economic issues on which to engage the European public (via direct election, referenda or juries) if Europe is to thrive in the new global economy. At the moment, there is a lack of the strong political leadership needed to help the European public understand and accept the challenges they have to face. It is better to decide cleanly what, if anything, we want decided at the European level and then create a directly-elected representative to wield that power (be it broadly or narrowly defined) in a strong and highly accountable way.

3) Directly elected Presidents for the UK nations

A third step might be to have directly elected Presidents for each of the 4 UK nations (Scotland, NI, Wales and the UK). In effect, this makes a formality of what is actually going on in elections. It’s clear, for example, that, in spite of the personal merits of local Members of Parliament, the 2015 General Election will boil down to whether the public wants “President” Cameron, Miliband, Clegg or Farrage. So why not let people elect them directly and then let the successful candidate choose who is in their government (as Obama does in the US)? If nothing else, it would allow people to have a national vote for a national government, where every vote counted, and it would require the winner to have the support of the majority of the electorate. Two features our Westminster system lacks. But how do we avoid the problem that directly elected Presidents are often blocked by other branches of Government? As we know, the US constitution was inspired by the Jeffersonian principle of giving government the least amount of power and then spreading this power across the greatest number of bodies. In the US (and elsewhere) we know this leaves gridlock and a public confused about who is in power and who is accountable to them for what. But if Presidents could stay highly accountable to the public, then would we even need the other branches of government – the lower chambers who legislate and the upper chambers who refine the work of the lower chambers? Instead, could we not replace these others branches with direct input from the public? For example, maybe big annual decisions (such as the Budget) or major primary legislation should be subject to a public online referendum. It ought to easy to make online voting easy, secure and, if necessary, frequent. It is no longer the case that communities which are days away from their capital need to send representatives to follow events and vote on issues. Modern media brings government and the people together in real time. In terms of shaping and debating legislation, maybe Presidents would be obliged to put all new draft legislation out to pre-legislative scrutiny. The power of the elected executive would be moderated by the people, in real time, rather than by other elected representatives, competing for legitimacy. (It’s entirely feasible that a ceremonial monarchy continues in this scenario, if that’s what the public wants).

4) Russian doll Mayors

Elected Mayors are a good thing. Like the Presidential model, having Mayors gives the public a direct vote for who they want to run the area and requires the winning candidate to secure a majority of the electorate. The challenge is that we need Mayors at different levels. On the one hand, there is a serious lack of big, strategic Metro Mayors for our larger conurbations. We have one in Boris. Should we have more? This could be for each of our biggest city regions (e.g. Birmingham, Glasgow, Liverpool, Manchester, Newcastle, etc). But we also need them at a very local level. In other countries, e.g. France and the US, there are mayors for very local areas, including the 37,000 communes of France and many of the 20,000 US municipalities. Just as in London, we have a Mayor for Hackney and a Mayor for London as a whole, fans of Danish TV drama will know that in Copenhagen local areas elect a Borgmester for their neighbourhood and an Overborgmester for the City as a whole. We could see these as Russian doll Mayors – we could have as many as we liked, with each smaller geography siting inside a large one. However, I suspect that for most people 2 would be fine. Again, rather than having lots of councillors to limit the power of Mayors, their executive heft could be moderated by direct public participation in online referenda or public juries on major decisions.

These are just a few ideas for reforming our political structures. There are many other, and probably better, ones that we should we considering. Indeed, there are other ideas elsewhere on my blog (e.g. hypothecating taxes, for example for the NHS) which could make a real difference. The straw man ideas in this post are about trying to move away from the indirect democracy which offers the public infrequent opportunities to express a view about who they delegate to represent them in a rather complicated, distant gathering of the political elite. Instead, these ideas aim to stimulate a debate about giving ordinary people more opportunities to directly express their opinions, to directly choose their leaders and to delegate their decisions to their peers for complex decisions best suited to a jury. If such ideas worked, they might reconnect government and ordinary people and reignite the political battle of ideas about what kind of future we want to pursue.

Five steps to save what really matters in the NHS and lose what gets in the way

Like the great majority of British people, I am immensely proud of the NHS and instinctively defensive when it is attacked. And yet, I am not sure many of us are very clear what we think the NHS actually is. Sometimes people think that it’s all a public service, but up to a third of the NHS funded staff work in profit-making private businesses (GPs, dentists, opticians, etc). Sometimes people mistake the professionalism of medics for the ethos of the NHS, when there is no evidence that medics in other countries are any less professional, or indeed that the same NHS medics are any less professional in their own private practice (e.g. hospital consultants). Many people, who have never known any other provider than the NHS, associate medical innovation and progress with the NHS, marvelling at the improvements in, for example, cancer care over the last 30 years, but without realising that the same (amazing) improvements have been made in other countries, often, sadly, to a greater extent. Much of what we admire about the NHS is what people in other countries admire about their own health services, public or private. It’s just that for 93% of people in the UK, the NHS is the only health service that they consume, so their admiration goes to the NHS. However, I am very clear what I care most about in any debate about health and the future of the NHS. Any visit to the USA always reminds me of what is actually truly special about the NHS. And that is the wonderful principle that people in the UK do not have to worry about whether they can afford the health care they need when they need it and the costs of that health care are paid for through a progressive tax on everyone. A textbook case of “to each according to need, from each according to their means”. Of course to many Americans (and some on the right in the UK) this sounds like socialism. But it’s unthinkable that we would move away from this principle. It’s an important moral principle that healthcare should be provided through social solidarity, across generations (as it’s mostly consumed by the very old) and across income groups (as the better-off pick up most of the tab). However, there is also plenty of pragmatic economic justification for this approach. Effectively, we are pooling risk. None of us know who will have the greatest needs. Nor do we know when that need will occur. So it makes sense to create the biggest risk pool possible. For me, then, what I want to defend, protect and enhance is the NHS as a national health insurance scheme – keeping healthcare free at the point of access, paid for by those who can most afford it in a major act of social solidarity, the key obligation that we decide to have to each other. That’s the kind of principle worth going to war to defend. But that’s the end of my socialism in terms of the NHS. I don’t accept that in order to have social equity we need to mirror other aspects of the Soviet system. It’s pretty clear that the current NHS provision needs a revolutionary dose of both glasnost and perestroika. On the other hand, there has been a lot of good reform, especially in the creation of new types of institution. But this reform has been hobbled by a lack of clarity of about what is and isn’t the NHS and an overwhelming and negative culture of bureaucratic paternalism, which aims to plan out the lives of both medics and patients, rather than letting them find their relationships in a competitive market. So here’s my thoughts on how to build on the current direction of travel in the NHS but make a revolutionary leap forwards, saving what matters in the NHS and destroying what hinders progress.

I suggest a 5 step approach:

1. We could declare that the NHS is simply a health insurance scheme – no more, no less. It would not be an employer, a provider, a planner of health services, a trainer of staff, etc. It could be known as NHS Insurance (NHSI). Its mission would be to fund high quality healthcare, free at the point of use to everybody based on need and funded through the tax system. We would ,therefore, maintain what is best about the NHS – that no-one should worry about whether they can afford the healthcare which they need when they need it; that healthcare is given to those in need, funded by those who can afford it. NHSI would set out clear, national entitlements as to what was covered by the insurance scheme, removing local policy choice. There would be vigorous political debate about the scope of the entitlements and the levels of funding provided. There would be an independent watchdog (probably, the existing NAO) to see whether NHSI achieved value for money in the prices it paid for health services and the clinical outcomes. 

2. We could take the NHS out of general taxation. Instead, National Insurance (NI) taxes could be renamed “NHS Insurance”. The rates of the NHSI would be set by the Health Secretary, rather than the Treasury. The money raised by NI (just over £100 billion per year) is almost exactly the same as the cost of the NHS. NI already looks like a health insurance scheme – it is funded out of earned income, with contributions from both workers and employers. It is a progressive charge – nothing is paid on the first £8,000 of earned income and then it is charged to employers (13%) and employees (12%) up to £42,000. After that, it is charged at 2% of income. Clearly there is scope to increase the rate above £42,000 as and when more money is needed. There is also the opportunity to remove some of the current exemptions and lower rates – e.g. for the self-employed and high income older people. The progressive nature of the insurance scheme could be fixed in primary legislation, but the details subject to political decision-making by serving Health Secretaries. Parties could therefore campaign to raise or decrease, or vary NHSI charges, quite separate from the general approach to taxation. This would focus the debate on how much people want to pay for healthcare. The current cost of the NHS is £2,000 per person per year. But as NHSI (replacing NI) would come out of earned income, the cost to those in work will have to cover children, the retired and working age people not in employment. This means that an average working age household, with a combined income of around £40,000 per year, would pay about £4,000 out of their salary. Their employer(s) would pay the same again. Both could be shown on the payslip – showing the average household that £8,000 (or c£150 per week) was being paid for NHSI. This should focus everyone’s mind on the cost of NHSI and help the public connect more clearly with the debate about “more, or less, money for the NHS”. 

3. As the NHS would no longer be a provider, we could transfer the ownership of NHS services to the staff who provide them. The majority of NHS funded organisations are already privately owned by the people who provide them – dentists, pharmacists, GP practices, opticians, etc. We could complete that journey for the other 1m staff – those working in hospitals, ambulance services and community services. At the moment, the ownership of many of these NHS services sits in a twilight zone – who owns a foundation trust? We could set a deadline for all current services to be taken over by employee-owned organisations. This could be, for example, all of a large hospital being taken over by its staff. Or smaller groups of staff (e.g. a pathology lab or a clinical department or a community mental health service) could opt out on their own. It maybe that some hospitals will want to make the hospital facilities a separate business from the staff who work in it ( in the same way that most private hospitals work). The new organisations could be for profit (like GPs or dentists are now) or not-for-profit (as BUPA is now), as the staff wish. The new organisations would, in the future, be able to merge, acquire or be acquired in the future, but only if a majority of staff shareholders vote for it. This is to stop a few people profiting from selling out their colleagues. 

4. Like other health insurers, NHSI would accredit providers, i.e. those it is willing to fund. This would cover the prices for services and the quality standards to be met. Accreditation would be open to any providers to offer any service – former GP practices might want to offer diagnostic testing in competition with hospitals; hospitals might want to offer GP services; a mental health practice in the North might want to expand in the South West; pharmacists may decide to offer a wide range of GP services, or maybe just a minor ailments services; etc. This is similar to the current philosophy of “Any Qualified Provider”, but with much more incentive for these now private providers to compete for service. Quality would be judged by the Care Quality Commission, as now, but NHSI would also need monitor outcomes and costs, taking over the role of (and people in) local Clinical Commissioning Groups. Where providers with critical facilities got into financial trouble or where competition was ineffective in a local area, the existing regulator, Monitor, would step in to protect consumer interests. In fact, the current NHS organisational structure would work well in this new world – it was designed to go in just this direction. 

5. Clearly, there is a risk that if ownership is fully transferred to those who provide the services they will put their own interests first, rather than patients. An obvious risk is that where medics or facilities are in scarce supply, the staff owned businesses will put up prices and increase their incomes. The best medium term way to avoid this is to reduce scarcity. The key scarcity is staff. The UK has one of the lowest numbers of doctors per head of population in Europe. In fact, it comes 24th out of 27, only managing to beat Poland, Romania and Slovenia. Austria has nearly twice as many doctors per head of population as the UK. Germany, Italy, Spain and Sweden all have more than 40% more doctors. The situation in the UK has got better – there are now 138,000 employed doctors, compared to just 102,000 10 years ago. Supply has grown through a mix of more training places and immigration – a third of hospital doctors are now foreign born. The current planned economy of the NHS limits the numbers of doctors – by fixing national pay levels it limits the number of jobs. It also sets pay at a high level. For example, in the UK GP partners earn something 3.4 times the national average wage, whilst in Australia they earn 1.7 times. That’s twice as much, in comparative terms. Whilst much of the problem in the absurdly expensive US system is high pay for doctors (e.g. orthopaedic surgeons earn twice as much in the US as they do in the UK, where they are the highest paid of doctors), in some countries (e.g. in central Europe) doctors earn less than the national average. There is no shortage of people, with the necessary talent, wanting to be doctors. So, we should push for a major expansion in medical training (e.g. 100% more doctors being trained?). Partly, this cost will be absorbed by student loans, partly it will be overseas students paying their own way and partly by NHSI on the basis that it will reduce future costs by increasing supply. A major increase in supply should encourage more people to go into unfashionable medicine (which has shortages) and the demise of national pay rates (given that all provision is private in this new world) means that doctor pay will be set by the market and doctor income will vary according to what they deliver.

5. After these changes, then we could get really radical. We could make it a truly patient-driven NHS. This is the current mantra of NHS managers. But they then often want to do the opposite – to have a “driven-patient” approach, creating pathways down which they wish to herd their sheep. A good example is the current NHS focus on trying to stop patients turning up at hospitals at their own convenience and getting them access to 9-5 community services instead. A patient-led approach would follow people’s revealed preferences – they are happy to visit a major outlet that offers better convenience and the promise of immediate attention. They do it every week at supermarkets. The average person only has 6 miles to get to their A&E, which has lots of fixed costs to sweat and assets to offer. It would be possible to offer a wider range of services on those sites, instead of trying divert demand away. In the current old world, NHS managers (of various kinds) sit around trying to plan out their options. I am not suggesting that they now plan out a new set of services on hospital sites. The key to this is to eradicate the bureaucratic purchaser or planner of services, currently known as commissioners. Instead, we could let patients choose what they want, in response to what competitive providers offer. NHSI would pay for the service, as chosen by the patient. In effect, we would be offering everybody (poor, average income or better-off) what today only the rich can have. In a new world where all health organisations are privately owned (albeit mostly by the staff who work in them) and all organisations are free to offer any (accredited) services to anyone they wish, we could let rip with patient choice. There could be 4 ways to put patients in charge:

(a) Direct access immediate services – This could include all those services where the public just wants to be able to turn up, find out what’s wrong with them and get immediate treatment. This includes GP services, paramedics and Accident and Emergency. For these services, we could say that patients can go anywhere they like – to any accredited provider. Rather than having to register with (and stick with) a GP, they could book an appointment anywhere, as they would for almost any other professional service in the private sector (e.g. seeing a solicitor). This would allow those who just want to see a doctor to see one. It would not prevent people who want it from sticking to the same doctor. The choice would be theirs. This would mean replacing the annual capitation fee with a fee-for-service, allowing the GP service to bill NHSI for seeing the patient. It would prevent the rationing of healthcare by GPs by how many of their (average) 1,575 patients they choose to see in a week. Clearly, it relies on all accredited providers being able to see health records. This may take a few years, but it is getting rapidly easier to achieve. (There are lots of ways to achieve it, including encouraging people to own their records on a cloud-based system, giving access to providers as they wish). Similarly, patients could go to any accredited A&E service. And of course, hospitals would be free to develop their A&E services to offer 24-7 GP services, whilst GPs could reciprocate with services for minor injuries or crises for those with long-term conditions; accredited pharmacists could offer a range of GP services, as could accredited mental health therapists. In all cases, providers would need to attract patients to have any revenues at all. Patients would have unlimited access to these direct access services, as they do now, funded by NHSI.

(b) Specialist diagnostic services – The second category of services is where patients are referred (by the direct access providers, e.g. GPs or A&E) for specialist diagnostics. This might be direct referral for tests (e.g. MRI scans). Or it maybe to specialist consultants for their opinion. Just as in private health insurance, patient access to these services would have to be through accredited referral. But once referral is given, patients could be given the same choice as they would get now with private insurance. They would be able to go to any accredited doctor or provider. Competitive providers would directly market to individual patients, offering, for example, faster access to testing, if people are willing to use facilities at weekends or evenings. Alternatively, many patients may just take a recommended routes from their direct access medic doing the referral.

(c) Planned services – Once a patient knows that he or she needs a time-limited course of treatment or particular service they would then have a choice about who they got that from. This would include operations, oncology, maternity, mental health, etc. They would choose accredited doctors or providers in the same way that they would with private health insurance. Again, providers would market themselves to individuals and compete on quality and convenience.

(d ) Long term conditions – The largest part of NHS spending goes on people with long term conditions. These are chronic diseases which can’t be cured, but which can be managed. This includes, for example, heart disease, diabetes, MS, arthritis, dementia and respiratory conditions. Government estimates that this is 70% of NHS spending. There is strong evidence that what works here is giving patients access to integrated providers – e.g. to an integrated dementia service (which includes primary, community and hospital inputs). There is also a philosophical commitment to given patients control over the health service they receive and more ability to self-manage their conditions. However, this is too often just rhetoric. A simple way to move this forward would be for NHSI to give patients with a LTC control over the budget. They would have to choose an accredited integrated provider – a prime contractor. That might be a hospital or a GP practice or a new type of organisation (e.g. Acme Diabetes). That provider would be expected to provide a full range of services (from regular checks through to urgent care) and they would need to configure professionals, technology and drug treatments into packages of care that attracted patients. They would have to resolve all the fragmentation across current providers into a simple package of care. Again, providers would market directly to patients and NHSI would set per capita prices for the annual treatment of the individual.

I would emphasise that these 5 steps fit easily into the journey already underway in the NHS. But the way that they fit together would remove the bureaucratic paternalism which currently gets between intelligent patients making their own choices and responsive medics creating attractive solutions to win the business of those patients. These suggestions therefore could accelerate the pace of the journey underway, but without jeopardising what I care most about in the NHS, the principle of access according to needs, payments according to means.