Not to disagree, but to add - even where ordeals are not consciously seen as beneficial, it is difficult to direct scarce policy-maker time and attention, and money, into reducing burdens and making systems easier to access.
There is always pressure to be able to announce or roll out a new initiative, and the amount of labour involved in building systems that talk effectively to one another and enable automation is often invisible to a team of civil servants designing a policy and almost always completely unimaginable to the politicians directing them. By the time the practical challenges of delivery are realised, everybody is committed to unreasonable timeframes, and rather than step back and fix the access problems the tendency is to push ahead and accept a messy or poorly-joined-up system. And then of course it's much harder to fix later, particularly as waves of technical debt build up across government.
For this reason I find it frustrating that people keep citing the speed of policy-making during Covid as a good thing: the Covid solutions were poorly thought through (of necessity, there was no time), some were incredibly effective and some faceplanted at once, the situation forced people to experiment (which is good) but also pushed us towards short term solutions and a 'pay for it later' mentality which left everything vulnerable to being slashed back in a swing back towards austerity once the immediate crisis subsided.
During Covid we had to use the levers we had, which meant that some groups unexpectedly benefitted and others suffered not because of any intent but because there was no existing lever and no time to build one (such as the newly self-employed, who missed out dramatically on furlough support).
So yes, absolutely, let's be more joined-up and stop letting arbitrary cruelty cost us more in the long run - but to do that effectively we need to really get to grips with the technical and practical investment needed to deliver that smoother, more generous system.
Really excellent to highlight the empathy gap, Sam, something not discussed enough. I’d add it extends to a variety of other issues, and suggests there are bigger, wider problems with our political culture and systems.
An example would be medics going on strike. Now I think people are broadly supportive of, say, junior doctors. But I think a problem in the past has been little real, lived understanding of exactly how stressful the job is, and how bad the compensation is compared to it. We all know being a doctor is stressful but I think it’s hard to appreciate unless you work in healthcare or have a close personal relationship with someone who does. My partner works in healthcare, and even I struggle sometimes to empathise with her because the pressure she’s under is so extreme compared to anything I’m used to.
Something I’ve become uncomfortable with in politics not just in the UK but elsewhere is a tendency to generalise. There’s always this sense that there are ‘real people’ who need to be spoken to. But this is simply not true. We live in diverse, complex societies where people have very different professions, personal backgrounds and social relationships. We have to recognise that, and any political institution has to be able to acknowledge this diversity and represent it.
Maybe we need to find a way to bring actual people from diverse personal and professional backgrounds in, not just as elected officials but in a consultative and deliberative way. An example I think of is in criminal trials, where juries become more empathetic towards defendants after they’ve heard their side of the story compared to just reading media reporting of the trial.
This is an excellent analysis and a very important contribution to our collective understanding of the terrible challenges faced by those most in need of state support. Policy makers should take careful note.
The word ‘ordeal’ is entirely appropriate. Should you wish for some specifics, Sam, based on our family experience, I can supply them.
An unintended consequence of the 5 week UC wait is that people won’t take short term paid work which might be good for career building but won’t pay enough to cover 5 weeks unpaid at the end.
And by trying to make the system more “efficient” the ordeals actually create more demand for other services and thus increase indirect costs as well as failing to reduce direct costs. John Seddon talks a lot about this “failure demand” across many public services and highly recommend his books such as Freedom from Command and Control
I agree with the conclusion that government rely excessively on ordeals ( and sanctions) and lack empathy. But in assessing whether ordeals work ( eg to reduce uptake ) it is important to assess their impact not just on the people subject to them directly but their impact on people who are potentially affected. For example, raising sentences for most crimes is unlikely to affect the behaviour of many of those most likely to end up being convicted because many lead chaotic and compulsive lives; however many politicians of both parties are drawn to increased sentences not just to demonstrate their concern but also to reinforce the incentives for the vast majority of people who might but don’t break the law. In the case of disability, there is a vast number of people who have disabilities but don’t claim because they don’t need to or don’t know what they are eligible for or are put off by the process.
Very helpful piece. The NHS is a highly success rationing channel that makes sweeping policy commitments but, by and large, prioritises service to those who need it the most, generally minimises the costs of uneven provision. But this sleight of hand has run its course. Scrimping on important interventions are building up a huge backlog which is part seen, part invisible. We see it most clearly in the impact on the economy.
Hi Sam. Always enjoy reading your pieces and this is an important contribution to the current poisoned debate - a thorough and well-considered outline of the problem. What do you see as the solution? Is there a model used elsewhere that would fit UK circumstances?
The sudden fall in homelessness in spring 2020 was one of the times I can definitely remember changing my opinion on something in light of new evidence - from "homelessness exists because eradicating it is really difficult" to "homelessness exists because the Tories don't care". (In general I think I may have a bias towards leaning too hard on Hanlon's razor to explain why the world is the way it is.)
I am late commenting but want to add that a significant portion of disabled people are not working simply because they are too chronically unwell. In these cases improved treatment options should be a higher priority. The last ONS figures, from I think March 2023, showed a little under 2m people suffering with long COVID where about a quarter were "limited a lot" in activities of daily living. Myalgic Encephalomyelitis or M.E. (often maligned as simply chronic fatigue) affects about a quarter of a million people in the UK many of whom are also too ill to work. It seems reasonable to wonder if these disabling and generally post-viral illnesses (that research suggests share aetiology and perhaps will share treatments in future) may affect the ability to work of a six figure number of people in the UK. On that basis it is hard to justify the paltry health research investments in such conditions especially when, at the more severe end, they tend to be lifelong, having started prior to middle age, and are enormously expensive to the state in both welfare support and lost tax revenues and economic activity. The US Congress dropped a bit over $1bn into long COVID research, which on a per capita basis would translate to over £200m. As far as I am aware the UK investment is a drop in that ocean. It seems pretty shortsighted for government to recognise COVID has led to reduced workforce participation but to do very little to seek treatments to get those significantly disabled by long COVID back on their (working) feet. Yale University's Akiko Iwasaki is building built a post-viral illness research lab and with luck treatments will come from there or groups in other countries, but it is a shame the UK is not joining the dots and continues to insist "coaching" will work. Sam's point that most do not need a push, they need help, feels right to me.
Not to disagree, but to add - even where ordeals are not consciously seen as beneficial, it is difficult to direct scarce policy-maker time and attention, and money, into reducing burdens and making systems easier to access.
There is always pressure to be able to announce or roll out a new initiative, and the amount of labour involved in building systems that talk effectively to one another and enable automation is often invisible to a team of civil servants designing a policy and almost always completely unimaginable to the politicians directing them. By the time the practical challenges of delivery are realised, everybody is committed to unreasonable timeframes, and rather than step back and fix the access problems the tendency is to push ahead and accept a messy or poorly-joined-up system. And then of course it's much harder to fix later, particularly as waves of technical debt build up across government.
For this reason I find it frustrating that people keep citing the speed of policy-making during Covid as a good thing: the Covid solutions were poorly thought through (of necessity, there was no time), some were incredibly effective and some faceplanted at once, the situation forced people to experiment (which is good) but also pushed us towards short term solutions and a 'pay for it later' mentality which left everything vulnerable to being slashed back in a swing back towards austerity once the immediate crisis subsided.
During Covid we had to use the levers we had, which meant that some groups unexpectedly benefitted and others suffered not because of any intent but because there was no existing lever and no time to build one (such as the newly self-employed, who missed out dramatically on furlough support).
So yes, absolutely, let's be more joined-up and stop letting arbitrary cruelty cost us more in the long run - but to do that effectively we need to really get to grips with the technical and practical investment needed to deliver that smoother, more generous system.
Really excellent to highlight the empathy gap, Sam, something not discussed enough. I’d add it extends to a variety of other issues, and suggests there are bigger, wider problems with our political culture and systems.
An example would be medics going on strike. Now I think people are broadly supportive of, say, junior doctors. But I think a problem in the past has been little real, lived understanding of exactly how stressful the job is, and how bad the compensation is compared to it. We all know being a doctor is stressful but I think it’s hard to appreciate unless you work in healthcare or have a close personal relationship with someone who does. My partner works in healthcare, and even I struggle sometimes to empathise with her because the pressure she’s under is so extreme compared to anything I’m used to.
Something I’ve become uncomfortable with in politics not just in the UK but elsewhere is a tendency to generalise. There’s always this sense that there are ‘real people’ who need to be spoken to. But this is simply not true. We live in diverse, complex societies where people have very different professions, personal backgrounds and social relationships. We have to recognise that, and any political institution has to be able to acknowledge this diversity and represent it.
Maybe we need to find a way to bring actual people from diverse personal and professional backgrounds in, not just as elected officials but in a consultative and deliberative way. An example I think of is in criminal trials, where juries become more empathetic towards defendants after they’ve heard their side of the story compared to just reading media reporting of the trial.
This is an excellent analysis and a very important contribution to our collective understanding of the terrible challenges faced by those most in need of state support. Policy makers should take careful note.
The word ‘ordeal’ is entirely appropriate. Should you wish for some specifics, Sam, based on our family experience, I can supply them.
An unintended consequence of the 5 week UC wait is that people won’t take short term paid work which might be good for career building but won’t pay enough to cover 5 weeks unpaid at the end.
And by trying to make the system more “efficient” the ordeals actually create more demand for other services and thus increase indirect costs as well as failing to reduce direct costs. John Seddon talks a lot about this “failure demand” across many public services and highly recommend his books such as Freedom from Command and Control
I agree with the conclusion that government rely excessively on ordeals ( and sanctions) and lack empathy. But in assessing whether ordeals work ( eg to reduce uptake ) it is important to assess their impact not just on the people subject to them directly but their impact on people who are potentially affected. For example, raising sentences for most crimes is unlikely to affect the behaviour of many of those most likely to end up being convicted because many lead chaotic and compulsive lives; however many politicians of both parties are drawn to increased sentences not just to demonstrate their concern but also to reinforce the incentives for the vast majority of people who might but don’t break the law. In the case of disability, there is a vast number of people who have disabilities but don’t claim because they don’t need to or don’t know what they are eligible for or are put off by the process.
Very helpful piece. The NHS is a highly success rationing channel that makes sweeping policy commitments but, by and large, prioritises service to those who need it the most, generally minimises the costs of uneven provision. But this sleight of hand has run its course. Scrimping on important interventions are building up a huge backlog which is part seen, part invisible. We see it most clearly in the impact on the economy.
Hi Sam. Always enjoy reading your pieces and this is an important contribution to the current poisoned debate - a thorough and well-considered outline of the problem. What do you see as the solution? Is there a model used elsewhere that would fit UK circumstances?
The sudden fall in homelessness in spring 2020 was one of the times I can definitely remember changing my opinion on something in light of new evidence - from "homelessness exists because eradicating it is really difficult" to "homelessness exists because the Tories don't care". (In general I think I may have a bias towards leaning too hard on Hanlon's razor to explain why the world is the way it is.)
I am late commenting but want to add that a significant portion of disabled people are not working simply because they are too chronically unwell. In these cases improved treatment options should be a higher priority. The last ONS figures, from I think March 2023, showed a little under 2m people suffering with long COVID where about a quarter were "limited a lot" in activities of daily living. Myalgic Encephalomyelitis or M.E. (often maligned as simply chronic fatigue) affects about a quarter of a million people in the UK many of whom are also too ill to work. It seems reasonable to wonder if these disabling and generally post-viral illnesses (that research suggests share aetiology and perhaps will share treatments in future) may affect the ability to work of a six figure number of people in the UK. On that basis it is hard to justify the paltry health research investments in such conditions especially when, at the more severe end, they tend to be lifelong, having started prior to middle age, and are enormously expensive to the state in both welfare support and lost tax revenues and economic activity. The US Congress dropped a bit over $1bn into long COVID research, which on a per capita basis would translate to over £200m. As far as I am aware the UK investment is a drop in that ocean. It seems pretty shortsighted for government to recognise COVID has led to reduced workforce participation but to do very little to seek treatments to get those significantly disabled by long COVID back on their (working) feet. Yale University's Akiko Iwasaki is building built a post-viral illness research lab and with luck treatments will come from there or groups in other countries, but it is a shame the UK is not joining the dots and continues to insist "coaching" will work. Sam's point that most do not need a push, they need help, feels right to me.