Conservative Home has started a series of posts at looking at ways to reduce the demand for government. The first post, by David Goodhart, is about family.
Goodhart notes that a country seeking to save costs (such as on social work and criminal justice) should consider investing in its culture and institutions, to develop a culture that is “high-trust, conscientious and collaborative”. Goodhart does not ask which countries in the world rank best for these markers, and what we might learn from those countries about what it means and whtat it takes to invest in culture and institutions. For example, does it require government funding, because after all no-one can work for free without an income source to enable them to purchase the fruits of other people's labour? Fortunately, other people have asked and answered the question of what makes for a strong country.
Greater income and wealth equality in a country is associated with improved figures on physical health, mental health, obesity, child wellbeing, teenage pregnancies, drug abuse, violence, imprisonment, education, social mobility, and trust and community life. Wilkinson and Pickett report that “levels of trust [of strangers] between members of the public are lower in countries and states where income differences are larger.”
Eric Uslaner reports that it is equality that drives social trust: “Countries with more trusters have better functioning government, more redistributive policies, more open markets, and less corruption. What distinguishes countries that are trusting from those that are not is the level of economic equality.” There is “no direct effect of trust on inequality; rather, the causal direction starts with inequality.” This is because “trust cannot thrive in an unequal world”, with inequality having a stronger impact on levels of trust of strangers than do unemployment, inflation or economic growth.
The obvious next question is, what makes for an equal country? Why are some countries more equal than others? Fortunately, we have answers to that too. Neoliberalism – the deregulation and opening up of domestic markets; and a smaller role for the state – leads to increased inequality. And increased inequality is not just harmful for social trust, as noted above, but for a wide range of economic, social and societal measures including long-term economic growth. Rabobank said of a 2016 IMF paper that it “argues for the reintroduction of some capital controls...and abandoning fiscal austerity policies." This comment, he says "is directed at Germany, the U.K., and the U.S. in particular”. Yet here we are, seven years later, seeing people call for more austerity.
Goodhart moves on to say that “stronger institutions can also save money”. Here, he does not appear to mean a strong government, with strength in institutions such as the NHS, social care, education system, policing, and criminal justice. Rather, he means social institutions such as the family. Goodhart says of the family that “it often does efficiently and for free what the state does clumsily and expensively”.
I think this overplays what families do, and the cost to the state and to the family. In my own family, I have seen the impact of my own overdose some years ago. Would I have pushed myself to that point of despair if the culture of the UK was not one of valorising the ‘hard worker’, even at the cost of sickness presenteeism? Learning to refrain from useful activity has been a core part of my recovery from depression, despair and panic attacks and a key tool in the management of my chronic physical illness. I have also seen the impact on my family of caring for an elderly relative with dementia; it tipped my mum into a breakdown. I have seen the same physical and emotional strain on other friends.
Speaking for myself and my own care needs, dependence upon family is not independence, and nor is it freedom to live a fulfilled life. Dependence upon family means being acutely conscious that everything they do for you is taken out of their own life, whether out of their ability to earn or out of their time for socialisation or even out of their capacity to cook and clean and do household chores. It means knowing that, far from enabling the carer, by paying for their time so that they have an income to live off, your need for care is disabling of their capacity for work and free time. It means knowing that they are poorer because of you: poorer financially because they are not working and earning; poorer socially because they are caring for you rather than being in a workplace or with other community and friends; poorer physically and emotionally because of their concern for you and your wellbeing and the impact that that has on them.
Dependence upon the goodwill and the capacity of my parents or other family members is not independence. What happens when they are ill, or tired, or have a breakdown? How do they get holiday and sick-pay? Where is my choice and control over where I live, and how, and who with; where is my choice and control over who washes me, or toilets me, or cleans my house, or cooks my meals? Ensuring healthy boundaries, healthy relationships, and healthy work-patterns for the carer mean that the carers should be paid a living wage for his or her work; work a limited number of hours per week; and have access to leave from work. None of that happens when the carer is an unpaid family member.
Unpaid care is also unfair to the carer. We all need money in order to purchase the items upon which we depend for survival, let alone to thrive and particpate in society. The work that we do, including work in caring for young children or disabled relatives, needs to be met with some form of 'voucher' that says that, because we have contributed to society through our labour, we are entitled to access the fruits of other people's labour. We could call this voucher 'money'. The government could hand out this voucher to people who are doign socially useful work such as caring, healthcare, social work, teaching, policing, refuse collection, road building, farming with conservation of nature, and much more.
Goodhart reports that the UK has the weakest families of any comparable country in Europe. But it is difficult to know what this has to do with state spending. Will reductions in state spending really strengthen families, or is it an increase in state spending - on social secuirty; on regulating low end jobs; on investing in welfare - that will strengthen families? Is the direction of causality csmple, or multi-factorial? How do we factor in decades of neoliberalism and the consequent need to spend large amounts in reactive rather than prevetative welfare? Unequal countries like the UK can end up spending more for worse results than a more equal country, because our failure to invest in prevention is costly.
The UK has low state spending, whilst Scandinavian countries are higher. Yet both have high fertility rates in Europe. Scandinavia has the highest first-marriage rates; but it also has the highest extra-marital birth rates. UK has the highest mean age at first birth; is middling for extra-marital births; and worst for divorce rates. Trying to disentangle this data to say whether state spending is good or bad – the implication of Goodhart’s piece being that it is bad – is challenging, when the correlations (so far as there are any) would seem likely to point in different directions.
Goodhart is right to note the costs of family breakdown. But it is interesting to put this into an article that is trying to make a case for less state spending. The way to reduce the costs of family breakdown is to invest in measures that support family relationships, such as a reduction in inequality and in poverty. But these cost money, particularly in the short-medium term, and only save money in the long-term.
So what is actually being called for is a bigger state: a preventative state. What is actually being posited is the left-wing economics of state investment in the expectation of seeing a stronger economy and reduced down-stream costs, not the right-wing economics of state-withdrawal in the expectation of seeing a stronger economy and reduced down-stream costs. Everyone wants a stronger economy and reduced down-stream costs; what makes the difference is how one believes that we get there. One side (right-wing; neoliberal; neoclassical) seeks to get there by first shrinking the state. The other side (left-wing) seeks to get there by first spending on public investment in the country.
Goodhart expresses concern that neither Conservatives nor Labour are willing to support parents staying at home with young children. I confess that until my sister had children, I thought that children staying at home with a parent until school-age (or even until 6 or 7) was the best thing for them. They should be with family, not a stranger. And then I realised just how boring, unstimulating and isolating it is for a child to be stuck largely in one place, with one adult for company, and only the same things to do day after day.
Whilst my eldest niece did not enter childcare until 1.5 years, and started on two days a week, nevertheless the childcare is a clear boon. She very much enjoys attending; it means she is less bored at home when she is at home; and she gets interaction with children and other adults that she cannot get at home. It is said that it takes a village to raise a child. This may be both because it is unfeasible to place all the burden upon a single adult, and because it is necessary for children to have social interaction with multiple people. Childcare is simply a way to create that village that sees the caregiver rewarded for the time put in, and the task delegated to one who positively enjoys and thrives in it.
There is a lot of data on the impact of children going to childcare: “Studies have linked daycare to children's behavior problems, failed to find a link, or found that daycare is linked to a reduction in such problems. Regarding cognitive development, studies have found negative effects, no significant links, and positive daycare effects. Research has shown that daycare hinders the quality of parent-child relations, does not hinder it, that the adverse effects are small and transitory, or intermittent. Early daycare has been linked to both problems in parenting and to improvements in parenting interactions.”
Overall, the evidence seems to that good quality pre-school childcare is good for children whilst bad quality childcare is bad; and too much childcare (over 40 hours/week regularly) or too young an age (less than 1yr) can also be slightly bad. Unfortunately, whilst I remember reading something along the lines of the last statement, I now can’t find it. There are plenty of papers out there; I would reference them all and try to synthesise them for you, but I’m tired and that’s not the sole point of this blogpost.
The main point is that Goodhart’s statement that “there is plenty of evidence that long periods of formal childcare between 0 and 3 does not provide the emotionally stable start that most children need” ignores that ‘there is plenty of evidence that formal childcare up to 40 hours/week between 1 and 3 years of age does provide the emotionally stable start that most children need, as well as boosting their cognitive skills and social development’. It’s just that different papers find different results; the quality of childcare matters; and it seems there is an age below which is too young (possibly around 1 year) and hours above which are too many (ten per day? 40 per week?). But for most children most of the time, good childcare is beneficial to them.
Goodhart writes that “Strengthening a sense of family obligation and making it easier for couples to come together and remain together, especially through the high stress years of young children and maximum work pressures, means leaning against some of the most powerful forces in contemporary culture, forces that promote short-term gratification.”
I am unsure if that is true. I haven’t looked into research on attitudes towards family obligations, but I’m very aware of the right-wing myth that poor people have a poor work ethic, and I’m very aware of all the evidence showing that the opposite is true: poor people have a very strong, tenacious work ethic. Much of this research also comments, albeit indirectly, on people’s family commitments. Indeed, it is this commitment to family that is accused of being a force for bad in the UK, because it discourages people from moving to find work. Well, you can’t have it both ways, right-wingers: do you want commitment to work above family, or to family above work – or do you want to go the left-wing route of investing in jobs where the people are, so that people can act out their commitment to both family and work without having to sacrifice one for the sake of the other?
“Not everything costs money”, writes Goodhart. “Politicians can contribute to shifting norms in what they talk about and the evidence they point to about families (and leading by example should not be required).” I’m not at all sure why leading by example should not be required! It is the height of hypocrisy to demand of others something that you are not prepared to do yourself. Moreover, it runs the risk of bad policy making, because the policy maker has no personal experience of the subject. When it comes to expecting poor people to pick up the state’s withdrawal from its responsibilities, the lack of personal experience really shows.
“Why is free partnership counselling not offered to struggling lower income couples via GPs or the benefit system?” Well, possibly because when the problem is poverty the solution is not counselling. Addressing symptoms when it is possible to address causes is an inappropriate strategy.
I agree with Goodhart that the tax and benefit system is “remarkably family unfriendly”. Most people are aware that the marriage tax allowance is small and could be much higher; indeed, a couple could be taxed as though they are one person. This is how the benefits system treats couples, in a deliberately punitive approach. It would be far better if benefits were given to individuals, without consideration of their relationship status; and tax allowances could be applied to couples who live together as a couple. But this would mean more state spending, not less.
Goodhart talks about measures to make it more affordable for one parent to stay at home for most of the time when children are pre-school. Most of the mothers that I know who had the financial choice, chose to go back to work because childcare is so much harder than paid work. Some who didn’t go back to work as early did so out of a committed belief that childcare below 1 or 1.5yrs of age is too soon; but the strain on the mother is huge.
Goodhart also suggests “encouraging more families to continue caring for elderly relatives, with appropriate social care back-up.” I strongly suggest that it should be the other way around. I have seen, far too much, the strain put on families when social care for disabled relatives is inadequate. I have experienced the knowledge of being the one who puts that strain on my family. I remain acutely aware of my dependence upon my dad for DIY, for social company, for transport, and for money. He should not also have to be coming in to cook and clean and do my laundry and hang out my knickers for me.
There is plenty enough for families to be doing for sick and disabled relatives that isn’t covered by social care. There is the transport to important appointments but also to social gatherings. There is the social companionship itself. There is the DIY and the admin and the financial management and the lawn-mowing or the yard-weeding. In fact, there’s a huge amount that social care doesn’t do; and what it does do, it does so poorly that it is often inadequate anyway.
Goodhart makes the familiar claim that spending on healthcare and welfare will only increase because of longevity, technology, and expectations; and that this is a bad thing. This is disputable, however. Whilst new technology is expensive, the cost of that technology tends to come down over time. Technology tends to increase productivity by reducing the labour time of a given activity, which thus saves on labour costs.
Where certain needs are best met by people - we are social beings, after all - then there is limited scope for proudctivity gains. And when other sectors can become increasingly productive through the use of technology and robots, the natural consequence is that socially-intensive sectors take up a relatively larger portion of the labour force. This isn't a bad thing. It is precisely what we should want to see: the redirection of people from jobs that can be done by robots, to thosewhere the customer is better served by a human.
People with chronic illness find themselves, after only two or three years, at the end of what healthcare can do for them. Our expectations are therefore low, because we know the limits of healthcare. And as we make up the bulk of healthcare spending, it is reasonable to consider that the majority of healthcare does not go on people with excessive expectations. Many of us, indeed, refrain from seeking healthcare even when there is a treatment available, because our experience tells us we will be dismissed. Low expectations may therefore drive prolonged illness, which is bad for society and the economy: social beings who want to contribute to family, friends and society are restrained by illness that could be alleviated.
Nor do I think that expectations can rise forever: what people want is to be fit and healthy; and people have always wanted that. This is also good for society, because it allows its members to participate fully. Illness puts strain on family relationships, especially when the state has decided to reduce its spending on healthcare and social care and social security in the name of strengthening the institution of family. Encouraging people to aspire to better things, and to ask the government to ensure
Other welfare and healthcare costs are contributed to by a lack of government spending. More unequal countries have worse health. Inadequate housing results in more trips and falls for elderly people; it also, alongside a lack of funding for social care, sees pensioners kept in hospital not because of health needs but because of unsuitable living arrangements. Toxic jobs – jobs at the low end of the labour market, with little autonomy and high pressure to work fast – contribute to ill-health. Sir Michael Marmot commented that the finance minister has a bigger impact on health than the health minister, because he controls the public purse, and his refusal to spend on preventative measures has large knock-on consequences.
I am keen to see a high trust, high welfare, stable family country. But as someone who expereinces life at the sharp end - where social care is inadequate; where the burden on family to care for children and sick relatives is huge; where social security is insufficient; where poverty is rife - I can assure you that it is not further reductions in state spending that will solve all this. If it would, our problems would have been solved some thirty or more years ago.
 Wilkinson R and Pickett K (2010) The Spirit Level: why equality is better for everyone. Penguin pg52-53.  Uslaner E (2002) The Moral Foundation of Trust  Rothstein B and Uslaner E (2005) All for all: equality, corruption and social trust. World Politics 58:41-72  Berg AG and Ostry JD (2011) Inequality and Unsustainable Growth: Two Sides of the Same Coin? IMF Staff Discussion Note Ostry JD, Berg AG and Tsangarides CG (2014) Redistribution, Inequality, and Growth. IMF Staff Discussion Note Ostry JD, Loungani P and Furceri D (2016) Neoliberalism: Oversold? Finance and Development 53(2) IMF  https://www.cnbc.com/2016/05/31/neoliberal-policies-have-led-to-inequality-imf.html  For clarity, I personally don’t need the first two in that list. But they are common needs.  Fitzsimons E and Villadsen A (2018) Father departure from the household and childhood mental health: how does timing matter? UCL Institute of Education Working Paper 2018/1  Shpancer N (17/10/2010) Is Non-Parental Daycare Bad for Children? Psychology Today https://www.psychologytoday.com/intl/blog/insight-therapy/201010/is-non-parental-daycare-bad-children