Gerry Fitzpatrick

26 July 2007

This series, written and presented by Alan Curtis, has a number of thematic links to other series previously broadcast on the BBC this year. The first is to BBC series on Victorian ideas of imperial and racial superiority over indigenous people and the second was the series lecture The Menace of the Masses: The Edwardians and The Birth of Now by John Carey.
 

Both these emphasised the importance of social Darwinism and the eugenics movement in forming and maintaining imperial ideologies of class domination at home and aboard. Their time frame ended with the rise of Hitler. In this series Alan Curtis beings in the Cold War era and attempts to show how this eras ideas about human nature shaped policy decisions and ultimately informed common place notions of what constitutes human nature and human freedom today.

No Over-arching Conspiracy

The first observation about the form of the series is that Curtis presents us with no over arching conspiracy of powers.  Rather; he shows how ideas were reworked and added to form an adaptable melange. His methods are very different from established documentary form, though he retains standard techniques, like his own voice used in voiceover and then in direct confrontation with many of the theorists he covers. His editorial innovations owe a lot to the French theorist of social control Michel Foucault.  Foucault, when writing, did not use standard introduction-exposition-conclusion structure, instead using a document or an event or an image, to capture the readers’ interest /imagination and then he would add on factually grounded material, moving on to a new image or event which in turn would be developed in the same way. So its not surprising that, as we are dealing with film, we see a number of interesting sequences of images that help give Curtis’s commentary momentum. A lot of sequences have been taken from early documentaries on human social behaviour, which gives an indication of the amount of time that has gone into researching this project.

Cold War Ideological Heroes

Given this approach it’s understandable that Curtis does not refer to the standard texts of the era which became ideological touchstones to the 50s generation of students. One was Daniel Bell’s End of Ideology which sought, following Burham’s book The Managerial Revolution, to explain why what existed in Russia and the West were not driven by ideology or politics, but by the need to innovate and manage the economy.  Therefore in Bell’s reductive approach the character of the status quo will remain the same because all other considerations; Ideology, history, are shown to be immaterial.

Skinner and Social Behaviourism

That’s on the macro political level. On the micro psychological level which the series also deals with, Curtis neglects the importance of behaviourism and the Social Behaviourism of Skinner. This set of ideas suggested that human beings can be controlled simply by giving them basic training - like animals. This was enormously influential and gave the eras conservative sociology an aura of prestige. In a series of infamous specially filmed demonstrations in the early 1960s Skinner appeared to show that if a disabled child was ‘rewarded’ with ice-cream, for saying a sentence it had previously been reluctant to say, then progress had been demonstrated.

The subject of these demonstrations was often a child with either autism or one or other form of mental disability.  Apart from the fact that this was in itself unscrupulous, it was also quite cruel in giving parents the false hope that their disabled children could be made to behave as if they didn’t have a disability. All that Skinner actually demonstrated was that the child could be made to act for food. Words were associated with ice-cream and not with communication.

Teaching a means of communication to a person with a disability takes time and resources and specialist knowledge - it is both a social and political question, (think of the cost of training teachers to teach sign language to the deaf and now think of the cost of teaching the non-deaf to use sign language to communicate with them).

But Social Behaviourism was one of a number of such ideological practices of ‘truth by reduction’ which began at the time of the Cold War, which assumed that human nature was in essence unethical and selfish.  Curtis in his documentary series mostly concentrates on the influence of similar and lesser known Cold War academic American theories. Selecting pressure points he gives an account of their impact and consequences.  The very skilfully edited film montage sequences of images from other documentaries are used here to good effect and they make us sit up and listen to the quick fire analysis and confrontations on the commentary.

John Nash’s Game Theory

Curtis begins by taking a look at how John Nash’s Game Theory was used in nuclear war scenarios to predict what the Pentagon thought the Kremlin would do. Many would have found this difficult to follow as the whole starting point of Nash’s theory was the idea that human beings given a choice of options, would act selfishly in order to ‘win the game’ – despite any positive or negative motivation . This can only seem bizarre to us today – especially when the game was the ultimate end game: thermonuclear war.  But of course there was logical reason why ideology had to be factored out - on both sides; it made the huge job of programming the clunking computer networks of the nuclear attack system easier. This lead to the Dr Strangelove’s (Edward Teller’s) scenario of  MAD (Mutually Assured Destruction) or rather, the propaganda excuse for America to keep building larger, and more weapon systems to assure the Russians of ‘total annihilation’ in response to one attack by them ‘anywhere in the world.’ There was one problem with this ‘programmable future’ – it didn’t work. Rather when it came down to it, the threat of total annihilation by B52s did not stop the Russians from building missile bases on Cuba in 1962. What did work was the negotiated withdrawal of American missiles from Turkey which had been aimed at the Soviet Union. And as the advocates of game theory would say ‘sometimes you have to let the other guy win –  to let him think he’s beaten you’ to which there can be only one reply –  ‘Game Over’.

Professor Eiendhoven Commander In Chief

Curtis charts the influence of this type of self-delusion all the way through the human sciences.  The presiding government studies guru in this sphere was one Professor Alian Eiendhoven who popularised the idea that efficient managers in any organisation were produced by motivating them to pursue ‘their own self interests’. Just how delusional he was about this project could be seen from his impish grin which he wore  while being interviewed by Curtis about trying to persuade the Pentagon to ‘get rid of the idea that the armed forces were driven by patriotism’ Curtis then comments, ‘you had a problem with the generals on that one’, ‘yes!’ Eiendhoven continued gleefully, ‘they were opposed to it!’ And judging by this response there must have been a high degree of joy from Eiendhoven as he assumed control of armed forces efficiency in the early 1960s. Now the generals would obey him, when up on until that point, Eiendhoven had only his academic researchers to boss about.

But Eiendhoven –  unlike the generals –  thought that army cadets were natural born, selfish, killers who would improve their military effectiveness if  given Skinner type ‘rewards’. Putting their minds in that new place above beyond ideology, their ‘basic’ selfish instincts would be set free.  But you can see the problem, if people had to be ‘rewarded’ to pursue their own natural selfish instincts - as Skinner had theorised, then that was not a condition of nature but an exercise in manipulation. And as the old brass might have pointed out, didn’t soldiers need to be trained and politically moulded too? And wasn’t that a more difficult task that involves trying to break someone, before you could actually mould them?

People in industry and in large organisations often wonder when the pointless and seemingly endless ‘performance reviews’ began, when their origins can be traced to these army studies designed by Eiendhoven to measure ‘leadership’ and ‘efficiency’ in the early 1960s. However, like any other civil service review of the work done by the civil service, it only succeeded in increasing the bureaucratic ranks. The rewards and commendations that were handed down were paper plaudits – which were more often than not rejected by old guard traditionalists.
For them the endless statistical ‘analysis’ of subjective observations did not tell and could not tell the whole story of the state of  the organisation and it was also a poor guide to morale. If you ever wondered why modern management politics has the undertow of an uncivil war - it is in large part due to the confrontation between the younger ‘analysts’ and the older deeply cynical seasoned professionals, who know that pointless paper exercises are just that and only succeed in having the opposite effect than that intended as they actually hinder judgement and effectiveness. 

At best Eiendhoven performance reviews ensured that the officer core was given some monetary rewards. For the most part they created legions of slide rule Milo’s who thought they were turning the old style military ‘circus’ into something approaching an efficient ‘amoral’ corporation. In practice, as Vietnam proved, they only succeed in creating an amoral circus.

The Denial of The Mandarins

But the denials of the Mandarins could be legion and Curtis makes the point very well when he shows what happened when this view of human nature and organisation was put into military practice in the Vietnam War.  If the officers could only increase the kill ratios per man as the analysts and their computers had recommended, then the war would be over.  The trouble was, as Curtis coolly reminds us, not only were the US soldiers falsifying their ‘body counts’ and kill ratios, but by the end of the Vietnam War the soldiers were also killing their officers in a number of ‘accidental’ explosions.  These ‘selfish’ acts were of course not factored in by the analysts. Why?  Because they had underlying ideological assumptions about what they were modelling. They simply did not accept that the soldiers could have done something else other than what they were told to do or, that the ‘ideological’ or group/national/military solidarity of the Vietminh would be more endurable than American computer driven effectiveness.

Parenthetically, this is known in sociology as ‘the curse of functionalism’ – treat all sociological aspects as a functional part of  a theoretical whole and very soon you will discover you can’t adequately explain why something or someone is being dysfunctional. (We have our own version of this in Northern Ireland academia called ‘carping functionalism’ – as in ‘the state responded and meet the demands of the Civil Rights movement therefore, the Unionist administration did not need to be brought down’.)

Anthropology in a Cold Climate

Perhaps if the mandarins had studied some anthropology they would have been able to see how kinship and group solidarity are not irrelevant or imponderable factors, but are in some cases the very essence of the matter – as they proved to be in Vietnam. But then as Curtis again showed in a subsequent programme, it depends on what type of anthropology you were talking about. For if you were talking about Cold War genetic determinist anthropology, then that is a different matter. Curtis shows an academics video. A violent tribal conflict explodes across the screen, suddenly the image freezes and we see diagrammatic arrows pointing at several of the heads of the warriors. We hear the academic on the commentary explain that those at the heart of the fighting on both sides, were defending those who they were the most ‘genetically close to’. A graph modelling the conflict appears on screen to reinforce the thesis.

Politically, this had become a common enough approach to human sciences in 60s academia; oafish lecturer begins by taking delight in demonstrating to his students that violence is simply part of human genetic reality and then capitalising on the discomfort of any radicals or peaceniks in the lecture hall.

This power relationship was neatly reversed by Curtis where the oafish lecturer is himself put in the position of the student, who has a few uncomfortable truths to lean. After we hear an alternative explanation of the violence of the opening film – namely that the reason why the men were fighting was that our academic had distributed axes and machetes to a small number of villagers so as to bind their loyalty to him for the purposes of his film making.  The confrontation that we saw was in fact a result of other men from out side the very small ‘sample community’ who had simply come by to ask for the use of the new tools and had been refused. This is understandable since it would have broken the agreement and been an insult to the weapons dealing visiting academic. Curtis then confronts the academic with these facts and then asks ‘and you don’t think that turning up with a film crew would not have an effect on people’s behaviour?’ ‘No, I don’t’ he replies and then promptly gets up and walks out of the room – where he himself of course was being filmed.  Curtis leaves it there, his point about the destructive relationship that had developed between the academic observer and his anthropological ‘subjects’ being well taken. And it can only be hoped, that as this programme can be viewed on-line, that those would-be students of  the good Dr X will think twice before signing up for one of his courses. They may also learn more from watching the footage of the actual fight that the academic based his ‘theory’ on.

For one thing it is noticeable that the fight itself is actually very restrained - there is a lot of shoving and sticks waving, but no one is actually seriously injured or killed. Which begs the question (even if someone was later injured), was this the end of the matter? – Or, as is common in tribal conflicts over resources, some later arrangement between the two villages was arrived at? Certainly, what this now very dated method of approach only succeeds in doing is to close off consideration of questions like this.

The Construction and Destruction of Choice

Curtis in the final programmes of the series then shows how these cold war approaches to organisation shaped contemporary conservative and neo-liberal approaches to the organisation of public services. He shows how the Tory and New Labour strategies of reorganisation actually produce the opposite outcome to what they had claimed. It was Mrs Thatcher who employed Professor Eiendhoven to reorganise the National Health Service along the lines of his previous approach to US military efficiency. Once again it was the ‘officer core’ of the NHS – its managers, consultants and GP’s, that were to be rewarded handsomely to pursue their own ‘self interest’ in order to guarantee that the system they managed would work better. In other words they were to be given large expensive ‘incentives’ while the wages of the rest would be held below inflation.

The theory was that those waiting for operations would see the benefits. What happened in practice was the exact opposite. The managers and their new over paid bureaucracy began to put the least urgent cases through the system to appear to be ‘bringing the waiting lists down’. Those who needed more complex and expensive operations were forced to wait longer.  The cost of the new management meant also that when expensive operations were being processed there was no money left in the hospital budget to pay for them (the costs of expensive operations had of course gone up during the longer delays).  Throughout the 1980s and 1990s NHS became progressively more top heavy and inefficient – by 2007 GPs were being paid up to three times what nursing staff were being paid.

Test Factories

The same processes of enhanced inequality can be seen at work in the Education service as a consequence of league tables. Those up and coming schools that had been able to give access to children who lived nearby in poor neighbourhoods, were squeezed out, as more middle class families moved into the school catchment area to put pressure on the admissions system. This meant that the struggling schools took in more disadvantaged students but were not given extra resources to cope. Consequently, many teachers began to leave the profession as their schools were transformed into government ‘test farms’ that did not improve the standard of education that the students received and actually began to reverse previous achievements.  The solution was to produce new ‘test factories’ – inner City Academies that would mop up the disadvantaged students. The prestige that the Blair government attached to these ‘public/private partnerships’ soon began to wear off as the task of reversing decades of inequality and disadvantage proved too much for those firms who were more used to training company graduates.

Support and sponsorship began to dry up and the government became desperate in trying to drum up private interest in the new inner city academies – this lead to the first honours scandal as individuals were promised honours in exchange for agreeing to become involved with the now failing academies. In any case, very few students could afford to go on to University as student fees had been introduced and increased. How the government thought that educational inequality could be reduced by re introducing fees for a University education is not such a mystery when we go back to the ideas of the Cold War gurus – who maintained that the best condition to be in is one of inequality which, freed from the ‘tinkering’ of government reformism (which they sneered at as ‘social engineering’) would produce the better outcome. 

Curtis then shows the effects of the fatal curse of the US Army efficiency studies - the new management system produces a mountain of lies so as to protect itself from other managers. Exams results, league tables and waiting lists keep on showing improvements, when using the most conservative sociological criteria it was obvious that huge inequalities were opening up.

Deadly Factor X - Centralisation

That said Curtis neglects the effect of an added management fetish which guaranteed that none of the new ‘innovations’ had any chance of working – centralisation. Centralisation of the NHS began under the Callaghan-Healy government as a consequence of massive public sector cuts. Beginning in 1976 some 48 local hospitals were closed in London alone and thousands more through out the country would also close.

Many liberals now claim that it was the Winter of Discontent that destroyed Labours’ chances at the 1979 election, when in fact it was the huge Union fight back that began in 1976 to keep these hospitals and other public services open, which saw the Labour movement re-enter politics. It was the immense conservative counter reaction to these campaigns that produced a yearning for a stronger government to defeat the Labour movement.  With further closures and privatisations under the Tories and then under New labour the real rout began.

The Rout

Denis Healy is very fond of telling interviewers that all the money that he borrowed form the IMF (the International Monetary Fund) was paid back. What he does not say was the funding cuts were never restored and hospitals stayed closed. The standard reply to how these services were to be replaced was ‘we are building a new hospital which will open in a few years.’  This would only open of course following more hospital, ward and A&E closures. Managed the new Eiendhoven way, where the admin was king, things in the new hospitals soon started to go wrong. First is the rather obvious point that if you have more sick people concentrated in one space the chances of higher infection and cross infections goes up. This also happens if you use cheap contractors who employ less staff to work on the difficult and complex job of keeping a large over used hospital clean enough, so that it can function – like a hospital.

Therefore once the superbug outbreaks began, wards and departments began closing more frequently and producing yet longer waiting lists. Having centralised services for three decades there was simply nowhere else for people to go. For the first time in an age people began to think of a stay in hospital as something that could seriously damage their health.  Patients who had been admitted on a management ‘fast track’ scheme for a routine operation ended up seriously ill or dead form MRSA or C Difficile. These bugs have been around for some time and there had been outbreaks in the past, but now even fewer people could be treated while the outbreak lasted, as there was no alternative hospital to go to. 

Before Denis Healy butchered the hospital system, it had had been able to cope much better with outbreaks, as they were much easier to contain and to control.  They were mostly caused by people infecting other patients and staff - something that could be addressed by isolating the person and the ward. Now it was the new hospitals themselves that were the problem. The safety in the system used to work on the same principle as the production of fireworks - smaller accessible units within an acceptable distance of each other, so if there was a fire/outbreak the other units/hospitals would not be compromised. Under this system it was much easier to recover from an outbreak, now under a much more centralised system it is much more difficult. 
The older form of organisation also worked much better in coping with long stays and repeated admissions that came with an aging population. With a number of smaller hospitals that had over the years attracted and recruited specialist staff more appropriate to the needs of local population, the system was able to manage and assess admissions more effectively. These smaller hospitals were used for recuperation as well as providing beds for patients who needed care while waiting for operations. This took the pressure off the larger hospitals, which were in any case then used for people who had more serious conditions or required more urgent specialist surgery.

A good indicator of what has been lost is the current rush to ban smoking. In the past when people smoked more than today, the health service was able to largely cope with the resultant serious illnesses such as cancer and heart disease, beds were found for these long stay patients. Now not only are stays in hospital a lot shorter, the government is actively campaigning against smoking as it costs the NHS and industry billions . This is despite the fact that the main political parties see nothing wrong in favouring those that own and profit from the tobacco industry. The new hospitals that have been built are a very long way from replacing the lost capacity and flexibility of the old system – especially when existing hospitals are closed to fund new builds. 

The Coming NHS Disaster

Two years ago an Oxford academic predicted that the impact of climate change would be much more devastating and far reaching than terrorism – his prediction is about to come brutally true. For the simple reason that following the floods people have started to get sick as a result of the loss of good drinking water and the effect of water borne bacilli. The hospitals are about to be put under more pressure than they have ever known. People are going to pay dearly for the destruction of the NHS network and its American inspired re-organisation so eloquently exposed by Alan Curtis in these films.