Blair’s unhealthy political vision

In a speech about public health, the prime minister declared open season on our private lives.

Rob Lyons

Topics Politics

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UK prime minister Tony Blair delivered a much-trailed public lecture this week on the future of ‘public health’. Actually, it was really a speech about the relationship between the state and society.

Blair told his audience in Nottingham: ‘For a hundred years or more the defining division in politics, in Britain and elsewhere, was about the role of the state. Essentially, progressives believed in its ability to improve society; conservatives feared its interference stifled personal liberty. The division became caricatured as between those who favoured a “big” state and those who favoured a “minimalist” one.… Underlying the formation of New Labour was really an attempt to consign such a division to the past.’ (1)

The immediate reaction of many was to condemn creeping privatisation of public services. As an editorial in the Guardian put it: ‘If the strategy is replacing state services with private facilities, ministers must explain the practical justification as they see it. If they are silent, or have no robust case, they will pay the political price.’ (2)

The lack of faith in public bodies to run public services is striking. While privatisation is usually promoted as a cost-saving measure, in reality the government happily pays more for the private sector to run services in many instances. However, all that was only one small part of Blair’s speech. What underlies his vision (for want of a better word) is the feeling that society is running increasingly out of control, and that new ways must be found to control the organisations and people within it.

Blair’s measures have come about as a result of the decline of the myriad institutions that used to glue society together, most notably the church, the monarchy, political parties, trade unions and the family. While these various institutions had competing interests in many respects, the existence of a relatively small number of bodies that could exercise influence over the mass of the population meant that governments always knew who to talk to, which loyalties to appeal to, and how to get things done. Now, even though the status quo is less threatened than at any time in well over a century, governments feel they have less control over society than before – and to some extent, they’re right (3).

It is no coincidence that the subject of Blair’s speech was public health, even though he was really talking about the state and society. That is because the provision of health – and the exercise of influence through health messages – has become central to the reformulation of the state’s relationship to society and the individual.

Blair said he will increase both choice and responsibility for individuals: ‘A state that sees its role as empowering the individual, not trying to make their choices for them, can only work on the basis of a different relationship between citizen and state. Government can’t be the only one with the responsibility if it’s not the only one with the power. The responsibility must be shared and the individual helped, but with an obligation also to help themselves.’

Bizarrely, even as he claims to be bringing the ‘nanny state’ to an end, it’s quite clear that Blair believes government should formulate what is good for us – and then, whether by persuasion or heavy-handed legislation, get us to do it. So on climate change, he said: ‘Government can give people the information, legislate and regulate to encourage sustainable living, help business to function in a more environmentally responsible way, work with other nations to develop the right international framework. But it can’t “do it” by itself. “Doing it” will depend on the decisions and choices of millions of individuals and companies. Our task is to empower them to make the right ones.’

This is a good deal more authoritarian than Blair would have us believe. Couched in the language of empowerment, in practice it means forcing through unpopular rules and regulations on recycling; banning smoking in public places; giving mothers the third degree if they can’t or won’t breastfeed; demanding that overweight people eat the right foods and do sufficient exercise; and various other measures through which the authorities will actually micro-manage our lives.

In the process, every aspect of daily life is instrumentalised, from getting our kids to play in order to meet an exercise target to the neighbourhood project that gets turned into a social inclusion exercise. Ask anyone who has ever tried to apply for funding from a local authority or a quango and they will give you chapter and verse on the ways in which your activity is transformed into a means for the authorities to meet various social, health or political targets.

It isn’t just individuals who should worry. Businesses are increasingly buried under a mountain of regulation, which shows that while the government has little faith in the public sector it is equally keen to keep the private sector on a tight leash, too. Blair wants to encourage greater participation by business in health initiatives, but if business doesn’t play ball, legislation will follow.

Blair argues that these interventions are no big deal. After all, he asks, didn’t people complain when governments decided to intervene to clean up big cities in the nineteenth century? ‘The role for government was clear. This required collective action. It meant property rights needed to be disregarded and land compulsorily purchased, both big issues for a laissez-faire time.’ But the comparison is a false one. Cleaning up a river, or building a sewage network, is beyond the capabilities of any individual and requires an organising body – which has become part of the state’s remit. Telling me how to live my life and to balance the (small, if any) risk of an early death versus the pleasure of a few vices is not the job of government.

What we need is not an ‘enabling’ government, if we’re only enabled to do what the authorities want. As Mick Hume has argued before on spiked, we need the power to make real choices, even if they’re the ‘wrong’ choices (see The more they talk about ‘choice’, the less we get, by Mick Hume).

New Labour has launched numerous attacks on our freedoms, both big and small. Now Blair says he wants government to be even ‘tougher, more active in setting standards and enforcing them’. The rest of us need to make a choice of our own: are we prepared to allow our lives to be run by others, or do we want the freedom to decide for ourselves how to live?

(1) Full text: Tony Blair’s speech on healthy living, Guardian, 26 July 2006

(2) Dancing with dogma, Guardian, 27 July 2006

(3) For more discussion of this, see The state, the economy and the politics of fear, by Phil Mullan

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Topics Politics


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