Monday, 29 April 2013

Alcohol policy and the industry


I feel that my previous post was a bit like weak academia, but what I hope to do with this one is illustrate how some elements of the model I proposed for understanding policymaking might be useful.

One of the debates I mentioned in my last post was about the role of the alcohol industry in policymaking.  This has been in the news, as a result of a report by Jim McCambridge, Ben Hawkins and Chris Holden which argued that the alcohol industry misrepresented research evidence in its submissions to the Scottish Government’s 2008 alcohol policy consultation, which included proposals for minimum unit pricing (MUP).

A lively debate followed (I found John Holmes on Twitter particularly interesting), and in one case strayed into a semantic discussion of the nature of ‘evidence’.*

The headline of a blog on the Guardian website presented the wider debate in stark terms: “Should those with a vested interest comment on minimum alcohol pricing?  This headline is itself a misrepresentation of the clear summary of the research Suzi Gage that followed.  The specific suggestion of the researchers is that ‘industry actors’ shouldn’t be involved in ‘the interpretation of research evidence’.

Thinking back to my previous post, this specific wording by McCambridge and colleagues really amounts to a claim that the alcohol industry isn’t the expert in what I posited as the second stage of thinking about policy: ‘what works’.  The gripe of McCambridge and colleagues is that the industry downplays strong evidence and promotes weak evidence or unevidenced conjecture in its place.

There is a statement in the article that ‘policy making is not a purely rational process, informed only by evidence.  It is by definition political and thus subject to a wide range of influences’.  I would take issue with this.  Policy cannot be solely informed by evidence, because evidence without aims is meaningless.  The decision on what these aims might be is certainly political, but that does not mean that it is by definition ‘not … purely rational’ – or more precisely that this somehow contrasts categorically with discussions of evidence.

What’s happening here is a prime case of the sort of problem L Susan Stebbing (the original thinker-to-some-purpose) was concerned to highlight.

It seems to me almost self-evident that the alcohol industry should be permitted to express its views on government policy, rendering the Guardian blog headline a bit of a straw man.  What’s at issue is quite how this should happen.  If we understand the injunction from McCambridge and colleagues as being that the alcohol industry shouldn’t get too involved in the ‘what works’ part of the policymaking process, this doesn’t rule out it contributing to the more fundamental question of ‘what is the problem’ (and what would be legitimate actions to address this).

This really hit home with me last November, when I was attending the DrugScope conference and felt that, regardless of my personal position, I could probably make the industry’s case better than Mark Baird was doing.  This is partly about not being so confrontational with those coming from a public health perspective, but it’s also about shifting the debate to ground where there is genuine uncertainty – and in fact there can never be certainty, because in this sense the decision is a political and moral one, rather than being simply about effectiveness.

The industry has a perfect right to sit at the policymaking table, but only as a stakeholder if it is being the industry.  If it’s trying to be a commentator on research evidence, you’re probably better off asking someone else (like McCambridge, or any number of other people).  The industry might commission research – but then you’d want to ask the actual researchers about the detail of that, rather than an industry representative such as Mark Baird (particularly given his slightly unusual definition of what constitutes ‘evidence’).

So, if I’m recommending shifting the debate to an earlier, more fundamental stage in that policymaking cycle, why, and what difference would that make?

Well, my first point is that all this industry ‘misrepresentation’ of research evidence isn’t a genuine debate about efficacy or effectiveness.  It seems fair to assume that the industry will continue to oppose intervention, even if in my view some explanations of why this is so (the shareholder imperative) are potentially a little simplistic in terms of their understanding of modern capitalism.**  Evidence can’t really change the industry’s position on intervention, because it’s based on economics and politics.

This applies not just to the alcohol industry’s position on alcohol policy, but to the issue itself in general.  The public health evidence can show that an intervention like MUP might reduce health harms across a population, or perhaps for a specific group; what it can’t show is whether this is a desirable aim, or (assuming health understood in these terms is a ‘good’ we want to promote as a society) how this balances against other potential ‘goods’ such as the pleasure of intoxication or the principles of liberty and autonomy.

L Susan Stebbing would probably argue that the industry should just come out and make this position clear, for reasons of transparency and so that we can have a constructive dialogue and genuine debate.  I’m tempted to think that, as well as this – in policymaking or public health circles perhaps – being open in this way would actually improve the industry’s standing.

Personally, I’m not sure that MUP would actually be an infringement of individuals’ (or corporations’) rights, but these sorts of arguments can’t be entirely undermined by predicted public health benefits.  When McCambridge says (in the radio link on the BBC article) that MUP would ‘benefit’ society at the expense of the industry, he’s assuming a particular view of the ‘good life’ and a particular conception of ‘society’ as opposed to ‘industry’.  These assumptions are not incontrovertible truths; they are particular ways of understanding the world.

If, in the mind of the public (or policymakers specifically), liberty and the pleasures of intoxication and taste trump living longer, that’s it – the argument is over no matter how effective a potential intervention might be.  And this would be without questioning the reliability or validity of the public health evidence.

In a sense, this is what McCambridge and colleagues are saying – as I quoted above, what they actually say is that ‘industry actors’ shouldn’t be involved in ‘the interpretation of research evidence’, and taking my model this would mean the industry wouldn’t have much of a role in the second stage – the ‘what works’ stage – but it might feed into the first: defining the problem.

However, I’m not sure how this could work out in practice.  I can’t really see the industry changing tack and being more open about their interests and objections.  (This is at a time when unfavourable comparisons with the tobacco industry are being made by McCambridge and colleagues.)  On the other hand, this doesn’t matter so much if we have policymakers and a wider public who are able to see the issues for what they are and consider them critically.

This idea of a public more willing and able to engage critically with public policy issues and cut through the rhetoric is at the core of L Susan Stebbing’s book, alongside the hope that politicians and other policymakers themselves might be clearer in their thinking and rhetoric.  Given that today, almost 75 years after it was first published, the arguments of Thinking to Some Purpose still seem directly relevant, it’s easy to be defeatist about the nature of public debate.  For the moment, though, I’m happy just to keep trying to follow Stebbing’s advice that ‘we should develop in ourselves a habit of sceptical inquiry’.

* Holmes also cited several other similar articles or findings.  One that’s quite informative is the discussion in response to this article in the BMJ.  I’m particularly interested in Don Shenker’s analogy with the car industry, where marketing a car on the basis of its safety record was apparently ‘anathema’ in the 1960s and 1970s.  (The discussion, under the tab ‘Read Responses’, seems to be free to non-subscribers.)
** On this front I immediately think of JK Galbraith’s idea of the technostructure, but there’s plenty of other work that critiques this sort of modelling of industry actors.

Sunday, 28 April 2013

Evidence in policymaking


Edit (30th April 2013):  As has been pointed out in the comments, it doesn't look like Ben Goldacre's tweet I mention in the highlighted section below was actually aimed at Jeremy Hardie.  I've left it there, though, partly out of transparency but also because the debate between them is still what sets the context for this post, though obviously there's also plenty of others contributing to this too (notably, for me, the British Educational Research Association - BERA).

I’ve been noticing quite a few discussions of evidence and policymaking recently.  There’s been a bit of a spat between Ben Goldacre and Jeremy Hardie, after the publication of his book Evidence-based policy: a practical guide to doing it better co-authored with Nancy Cartwright.  At least, I assume that’s who Goldacre was getting at when he tweeted:



This is presumably in response to Hardie’s IPPR blog post, which itself was a response to Goldacre’s Building Evidence into Education report.  (And around we go…)

Also, this week has seen the publication of a study suggesting that the alcohol industry’s evidence to the Scottish Government was misleading.  This led to the inevitable exchanges on Twitter between Mark Baird and John Holmes, amongst others.  I’m going to write about that specific issue separately, but the point here is that there’s much to be discussed about evidence and policy.

What I want to do here is offer a model for understanding policymaking that, I hope, helps shed some light on – and cut through – some of these discussions.

I know that there are plenty of models of policymaking already available in social policy textbooks, and I’m sure I’m reinventing the wheel at some level.  However, I want to be clear about what I’m trying to do with the model.  This isn’t about modelling how policy is made in practice and the variety of influences on it (though there are plenty of models for this).

What I’m trying to do instead is think in a slightly abstract way about how policy is made: what thinking or ideas underlie policy?  That doesn’t mean that this thinking is overt, or that policymakers themselves are always conscious of it, but (even if it’s only implicitly) positions are taken on each of the following aspects.  I would suggest this model is helpful for looking at existing policies, or policy debates, in order to better understand some of the currents and influences that are underlying them.

I hope that you’ll be able to see how it’s helpful to identify (sometimes hypothetical) steps in policymaking, conceived of as a problem-solving process, from my next post, which will be about the role of the alcohol industry in alcohol policymaking.

It also helps shed light on my earlier post about alcohol and neoliberalism.  If we can see that a ‘problem’ and ‘solution’ have been defined in particular ways, we can start to think whether there is a broader approach to the idea of government and policy that is affecting how people approach certain issues.

However, I’m keen to stress that this is just some thoughts about how to think about policymaking that have come to me recently; this post shouldn’t be taken as an attempt to produce a definitive model of policymaking.  I’m sure people will be able to spot gaps in the argument, or perhaps misunderstandings of certain policy areas.  If you do, please let me know, as it will help my way of thinking about policy.  Certainly, there could be more or fewer steps to the model.


1. What is the problem?
‘Problem’ is a bit too specific a word here, really, but any policy has several aims, which might be understood as attempts to solve certain problems.  One of the things that fascinates and frustrates me about alcohol policy is that there’s any number of aims – and that’s crucial for all the stages that follow.  However, whether it's stated clearly or not, there will always be some perceived ‘problem’ underlying a policy.

2. What works?
This is seen as a key issue in current politics.  It’s what’s behind the Goldacre-Hardie spat and, having been a key part of Tony Blair’s rebranding of the Labour Party, this precise phrase is now the title of new independent policy advice centres set up by the Coalition Government.

How to judge ‘what works’ is what Goldacre and Cartwright & Hardie discuss, and with more detail and insight than I can here – or could even if I had more time and space.  The point I want to stress here is that this is not a neutral, value-free question, because it presupposes an answer to the previous one: what are we trying to do with the policy in question?  You can only judge whether something ‘works’ if you know what its aim is.  A computer doesn’t ‘work’ very well for cooking a roast dinner, but it might ‘work’ for looking up advice on how to do this.

There are two issues with this.  First, as I’ve already stated, there’s very often multiple aims of policies – and sometimes these can even be in conflict to some extent.  A drug treatment policy might want to increase the number of individuals who are free of any drug dependence, but you wouldn’t want to do this at any expense.  There’s a possibility that the same policy that successfully pushes a lot of people through the system successfully leads to others feeling alienated, and they therefore go on to disengage and commit more crime, suffer more health harms and so forth.  That is, you can’t judge the policy on one aim, or on one metric.

This brings me to the second point.  The measurement of ‘what works’ depends on choosing some way of measuring success and failure – ‘operationalising’ your concepts, as I was taught.  This is where there’s often disagreement about education policy: do rises in GCSE pass rates indicate a successful policy, or is this metric inadequate?

Ben Goldacre, in his paper on education and research, suggests that most of the time this operationalising isn’t an issue, as we should be able to find decent metrics that we can agree on.  To a certain extent this is true – we could perhaps develop better metrics than GCSEs or SATs, or we could contextualise them to understand what they ‘really’ tell us about the standards of education in the country.

However, this only brings me back (again) to question 1: what are we trying to do with education policy?  When people disagree about standards slipping, this isn’t simply because they don’t have faith in the exam system; they’re also often expressing an underlying difference in opinion about what examination is for and, more generally, what education itself is for.  It is impossible to agree on a metric to measure the quality of education if we can’t agree what we’re trying to do by teaching someone history, for example – and there’s any number of things we might be trying to do, perhaps all in combination (knowledge of dates, an understanding of the human condition, an understanding of the evolution of the British institutions of government, an ability to think analytically and assess claims of evidence or causality, etc etc).

I realise that this makes the idea of this sort of model questionable: if we can’t have a single measure of ‘what works’, then what is the help of this concept in a model like this?  My point is that by looking at a policy and thinking through what the phrase ‘what works’ might mean, we can begin to see the assumptions that underpin the policy area.  If we were to analyse the new curriculum, or the 2003 Licensing Act, or the recent Higher Education reforms, we’d find implicit answers to these questions (even if they were only: aim to save money, does it work measured by whether or not the deficit is technically reduced).  These help us understand what’s actually going on in policymaking, and I’d hope give us some idea about the process could be better.

3. How does it work?
This is really where Cartwright and Hardie attack Goldacre for his emphasis on RCTs (randomised control trials).  They say that RCTs can’t tell you whether something will work in a different context.  This is part of the more general point that RCTs can’t tell you how something works – that is, what the precise features are that deliver outcomes.  I don’t want to enter into this discussion now, but this is a key stage in the process, because it adds to the next stage…

4. A model for intervention
This is something that actually comes out as the ‘solution’ to the problem, and depends upon a belief that something ‘works’, with assumptions about how it works.  I’m thinking really of something like NICE guidelines for the medical profession:
  • There’s a problem of heroin addiction, and we want to make sure individuals are no longer physically dependent on using heroin or other opiates.
  • We’ve done studies of replacement therapies and found that in general prescribing methadone seems to ‘work’ towards this aim reasonably well.
  • This is because it satisfies the body’s craving for opiates/opioids.
  • Therefore, here are some recommendations for how to deliver this initiative (NICE guideline TA114)

However, in reality you might find that the guidelines aren’t actually that specific or tailored, and leave plenty of room for manoeuvre.  Certainly this is the case with the guidelines for the specific example I’ve just given.  This means that in practice we often have a further stage before there are actually interventions affecting people’s lives…

5. Application of guidelines by experts
In the methadone example, here we move to treatment staff actually putting a package of care in place for an individual service user, which will (we might hope) be based on NICE guidelines, but which we wouldn’t be able to exactly predict because it also depends on the application of context and clinical judgement.  In education policy, we might think of the national curriculum being the ‘policy’, and then the application of this being actual lessons.*

There is then something of a cycle taking us back to the beginning.  Doctors, in Goldacre’s example, implement guidelines, but on the basis of intuition, or performance data, identify new or continuing problems, which the NIHR can then investigate, taking us back to step 1 of the process.  Alternatively this might be done by some kind of policy review.

Thinking through these steps, I’m not sure that there’s always a 5, where guidelines/regulations are implemented by ‘experts’.  In terms of MUP, for example, I can only really think that this would imply some kind of inspection regime to ensure that prices in shops were indeed at least at the threshold.

Conclusion
I’ll finish this post in the same way I started it: by stressing that these are only some basic reflections about how implementing policy entails certain conclusions to have been reached.  I’d really welcome responses that critique this model, or potentially refine it, as something like it is the way I approach public policy discussions at the moment, and any improvement on my thinking would be welcome.

* This is where Hardie’s citing of Hayek’s Use of Knowledge in Society comes from.  (I didn’t really need to mention this, but otherwise there wasn’t going to be a footnote in this post, and that just seems a missed opportunity when all the others have them.)

Friday, 19 April 2013

Nudging and Rationality


I’ve promised myself I’d write something about ‘nudging’ on here, so here goes.  It’s really only some initial thoughts, and it’s more about the principle than the detail, but hopefully that will come across and be interesting.

I’ve written here before about how nudging isn’t necessarily new (look at James Kneale’s work on the interest during the nineteenth century in governing the shape and design of pubs), and as part of this how it’s consistent with ideas of neoliberalism.  Sometime in the future I’d also quite like to write about how it doesn’t really mark anything of a ‘third way’ between intervention and laissez-faire, but that’s not too dissimilar an argument to the one about neoliberalism.

What I want to talk about here is how I see a misunderstanding of human rationality and desires at the heart of the ‘nudging’ approach.

Underlying the idea of nudging as outlined by Thaler and Sunstein and those analysing their work (like Marteau and colleagues) is the understanding that two contrasting systems drive human behaviour.  One is a reflective, goal-oriented system; the other an automatic, unconscious system based on emotions/affect.  I found this idea to be explained clearly and simply by Dan Gardner in his book Risk.  He uses the terms Head and Gut to describe the two systems.

Thaler and Sunstein relate this duality to classical versus behavioural economics.  Classical economics, they say, treated people as if they only used Head – as perfectly rational, calculating individuals with access to perfect information and plenty of time to think.  In reality, we humans are flawed and use Gut quite a lot – often to ill effect.  Behavioural economics is seen as an improvement on classical economics, as it accepts that people are irrational, but continues to seek to model them.  As Jones and colleagues put it neatly, it seeks to render them ‘predictably irrational’.*

Thaler and Sunstein then take these insights as to how people behave irrationally in order to change their actions so that they are ‘rational’.

However, in my view this is slightly to misunderstand the motivation of classical economics.  It is not concerned with thinking about people’s inner monologues; it is concerned with modelling how they actually behave.  This is a common theme in social research, perhaps most vociferously put forward by David Silverman.  (This is not to say that at other times we shouldn’t be concerned as much with what people say as what they do.  I would of course humbly suggest that my work on drinking and distinction, and its implications for alcohol policy, is a case in point…)

In classical economics we don’t always have to worry whether someone ‘really’ wants the chocolate bar in the long run; we’re more concerned with how much they’re prepared to pay for it in practice when they get to the checkout counter.  That is, whether it’s Head or Gut, the point is modelling the decision and what this tells us about people’s expressed preferences.  This decision can’t really be ‘irrational’ in any meaningful sense, from this perspective; it’s merely expressing the way this person has (unconsciously) balanced present pleasure with future health and wealth.  That is, there isn’t really a reason to see the person as ‘predictably irrational’ unless we’re concerned with understanding the disjuncture between what they say and what they do.

This is revealing of the ‘nudging’ perspective on rationality.  Rather than assuming, like conservative philosophers such as Michael Oakeshott and John Gray, that humans are incorrigibly irrational, Thaler and Sunstein want to re-mould them as more rational.

Oakeshott and Gray would consider this not just a vain, but a dangerous aspiration.  I don’t want to get into that argument now (though I have some sympathies with it), apart from to note that ‘rationality’ as an aspiration can be problematic for policymakers as they often see rationality (like Thaler and Sunstein) as decided by final outcomes rather than the process of thinking.  Smoking or drinking to drunkenness are not by definition irrational; they are only irrational if they don’t reflect how a person ‘really’ values their future health compared to their current pleasure.

This brings us round to this idea of ‘real’ preferences again.**  Thaler and Sunstein are concerned to demonstrate the falsity of the (straw man) claim that ‘almost all people, almost all of the time, make choices that are in their best interest or at the very least are better than the choices that would be made by someone else’.

For this statement to make any sense, it seems to me that we first need to understand what ‘best’ choices are.  Mill might make the suggestion that there are many different ways of living, and any individual with a ‘tolerable’ amount of common sense should be trusted to make their own choices.  Thaler and Sunstein don’t agree, as shown by their analogy of making life choices: a novice playing an experienced player at chess.

Not only are the aims of chess clear (to win), but the rules are also laid down formally.  We can imagine that different people might have different rules (or conventions or scruples) for going through life, but more importantly we certainly don’t agree on what the ‘aim’ of it all is.  The analogy is bizarre – who is a grand master at living?  Can we all agree who that might be?

One might generously assume that they mean something more like every individual is playing their own ‘game of life’, with their own aim and rules.  However, there remains this assumption that even for an individual there is a clear goal.  This is clear from the writings of the LSE philosopher Luc Bovens.

Bovens is very much in favour of nudges – he goes so far as to say that we should be considering ‘whatever works’ and these could well work so we should not be concerned about ‘ideological commitments to . . . human agency’, for example.  This raises important questions about how we might assess whether something ‘works’, which I’ll come back to in a later post, but for the moment I want to think about how Bovens judges whether or not nudges are legitimate.

Rather than some idea of preserving liberty, or an individual’s personal choices, he takes Thaler and Sunstein’s approach that we should be trying to help people make choices that are ‘better’ than the ones they make for themselves, and judges that an intervention is reasonable so long as it maintains a person’s ‘preference structure’.  This is defined as a consistent, coherent ‘conception of the good’.

Note that Bovens is not suggesting we do actually behave in accordance with such a structure; the whole reason we need to be ‘nudged’ is that we don’t.  As he puts it, ‘We choose on the background of a fragmented self’.  The aim of nudging is to put us together into a coherent self.

To me it seems completely impractical that we could work out what someone’s putative ‘preference structure’ is (what actions should be discounted as mistakes, and what as reflecting the underlying ‘reality’?), but the issue isn’t one of practice but theory.  That is, I don’t believe this is even theoretically possible – still less desirable.

As John Gray suggests, there are many competing desires, identities and communities within societies – and indeed within individuals themselves – and no single rational solution to balance them up.  Moreover, these desires aren’t consistent over time and they won’t all reflect a coherent view.

Given that the most outstanding philosophers across the ages have struggled to put forward a coherent, consistent worldview, it seems unlikely that the rest of us will have mastered one in our everyday lives.  What is the singly expressed ‘aim’ of your life, by which your ‘rationality’ can be judged?  How can intoxication be weighed against health; or reading against playing football; or cake against cheese?  Which should I be ‘nudged’ towards?

Although Thaler and Sunstein mock classical economists with their homo economicus, they are actually lamenting the nature of the human condition – they would like people to be more like this fiction.  Nudge is a manual for how to deal with the fact that humans make ‘bad’ decisions – defined as those they wouldn’t make ‘if they had paid full attention and possessed complete information, unlimited cognitive abilities, and complete self-control.’  As they would be the first to point out, this calculating ideal doesn’t sound like a human – and I’m not sure I would want to live in a world where people behaved like this, even if it were only through ‘nudges’ from on high.  Is a world led solely by the Head an attractive vision?  (And whose Head?)  To err is human.

* I’m not sure this phrase is theirs originally, but it’s through their work that I’ve come across it.
** This is particularly interesting in the field of addiction.  Thaler and Sunstein, like many others, cite the example of smoking, and how the ‘overwhelming’ majority of people want to quit.  This is fascinating for me, as in discussions of addiction and treatment reference is often made to the idea that a person needs to have a ‘genuine’ desire and commitment to change, and this is quite different from simply stating that one would like to quit (particularly in a world where addiction is stigmatised).

Although I’ve not referenced them directly, my thinking on nudging has probably been coloured by reading Amir & Lobel, Burgess, Goodwin, GrĂĽne-Yanoff and Selinger & Whyte.

Thursday, 11 April 2013

Neoliberalism, Thatcher and Alcohol

In the past few days, all forms of (social) media seem to have been full of evaluations not only of Margaret Thatcher herself, but of her legacy.

Was Thatcher an ideologue?  (No, The Times says.)

Was New Labour Thatcherite?  (Kind of, say Philip Collins and The Independent.)

Is the current Conservative Party Thatcherite?  Is the Coalition Thatcherite?  (Yes to both, says Owen Jones.)

Is Thatcherism neoliberalism?  (Not really, says Jon Agar; yes, says Alex Callinicos in the Socialist Worker.)

Are we still living in a neoliberal political environment?

It’s this last question that I’m most interested in.  All this debate seems rather timely – and almost jarring – given that it has become common for bloggers, political commentators and academics to suggest that we are living in a world that is no longer neoliberal – and perhaps even no longer liberal.  There’s an apparent emergence of what’s variously called things like postliberalism (that’s the political commentator and blogger) or neocommunitarianism (that’s, unsurprisingly, the academic).

The 2008 crash is said to have shattered people’s faith in markets and the rational individual.  William Davies identifies two key features of this world.  First, ‘individual consumer choice and egoistic desire . . . appear fallible’ and even ‘dangerously disruptive’.  Second, the ‘price mechanism of the market’ is no longer trusted to bring about social coordination.

In tandem with this, therefore, classical (or neo-classical, or neoliberal, or monetarist) economics has been replaced by behavioural economics as the go-to theory for Conservative leaders, it seems.  If government policy has one unifying factor, it is perhaps the reverence paid to the ‘Nudge Unit’ (or Behavioural Insights Team – BIT).  Richard Thaler and Cass Sunstein – authors of Nudge: Improving Decisions about Health, Wealth, and Happiness – have been high profile intellectual influences on David Cameron’s Conservative Party for some time now.

It’s this background that leads people like Ben Macintyre musing that ‘the Thatcher Revolution seems oddly vulnerable’.

On the other hand, people like Lynne Segal, in the wake of Margaret Thatcher’s death, have been stressing that her real and lasting legacy is ‘the ubiquitous rule of market forces’, tied explicitly to an idea of neoliberalism and currently being ‘more viciously enforced than ever’.

So, who is right?  Is behavioural economics so at odds with neoliberalism?  Is nudging – and ‘libertarian paternalism’ – so at odds with Thatcherism and its emphasis on the choosing individual and the value of markets?

All this hangs, for me, on how we understand neoliberalism.  I’m going to use it here as a way of understanding an actual approach to government.  I’m seeing it not as a coherent, pure ideology but as a ‘mentality of government’ – a set of assumptions and beliefs that affects what you see as possible and desirable in government.

This understanding makes neoliberalism something different from the way that Davies characterises it in his article ,suggesting that we might now be moving into a neocommunitarian age.  He suggests that current thinkers like Philip Blond or Maurice Glasman wouldn’t actively associate themselves with the neocommunitarianism label, but it’s a helpful way of grouping them together – and this is a contrast with neoliberalism, which Hayek and others actively embraced as an epithet.  I’m thinking more of something along the lines of Thatcherism, with the understanding as described by the Times obituary: ‘In practice her ideological attachments and prescriptions owed more to her gut feelings than to any works of political philosophy.’

Taking this approach (of neoliberalism as a practical mentality of government), a common way of dividing up recent history is to see: (i) classical liberalism broadly through the Victorian era, followed by (ii) the ‘expansive’ liberalism of the consensus years (which could start as early as post-WW1), which is then in turn replaced by (iii) neoliberalism under leaders like Thatcher.

Classical liberalism can be seen as identifying certain areas of life as instances where the individual knew best about their own interests, and should be left to their own devices – the family and civil society (or the market) being the key spheres.

In expansive liberalism, it’s noticed that actually leaving people to their own devices doesn’t always produce the outcomes a society might want at a ‘macro’ level, and so interventions are introduced.  These focus on re-shaping the structures in which individual decisions are taken – tripartite bargaining, the welfare state and so forth.

In neoliberalism, perhaps in two stages, some of these controls on the market or individual decision-making are dissolved, and in addition market mechanisms are introduced where they might not have existed before.  So you might see institutions of the expansive period exposed to market mechanisms.  Maybe this is private companies doing rubbish collection for councils, or hospitals farming out cleaning contracts.

Government retains – perhaps even more so than under classical liberalism – a view of how it would to see citizens behave.  However, people being people, they continue to fail to behave in the way government would hope.  Rather than changing the structures around them – the technique of expansive liberalism – neoliberals keep the market structures and try to change the citizen, using ‘technologies of citizenship’.  These could be forms of education, or more coercive forms of restraint – but targeted rather than universal.

Of course, these characterisations are an exaggeration.  Periods of history don’t divide up neatly like this, and there have been elements of all approaches across them all.  The Victorian era saw all sorts of forms of intervention in and regulation of the market – the factory acts could be just one example – and the idea that the social policy measures of the 1945 government represent a seismic shift in light of the Beveridge Report is a bit harsh on Lloyd George and the Board Schools and all sorts of other initiatives.  Without going into a discussion of nineteenth- and early twentieth-century liberalism, it’s worth noting that the Liberal Party (or parties) was/were not always ‘classical’ liberals in the sense I’m meaning here.

In that case, why are the monikers helpful?  Is an argument about whether we’re living in a neoliberal age simply a matter of semantics?

I think they’re still useful and important because at least the debate around them can help us see how mentalities of government are being shaped – and these ‘mentalities’ affect what politicians, commentators and the wider public see as desirable and possible.  There’s a power to the idea that ‘there is no alternative’ if you can make it stick.  That’s the power of ideology, orthodoxy, doxa or whatever you want to call it – maybe hegemony?  For better or worse I’m not too bothered about the label and any philosophical terminology and distinctions; I’m simply trying to highlight what key assumptions might still be underpinning and structuring policy thinking today.

In that light, let’s take the example of alcohol policy.*  In crude terms, it might be argued that the nineteenth century was an era of liberalism.  The Beer Act of 1830 can be seen as liberalising the sale of beer (if not alcohol more generally).  In the decades leading up to this act, commentators had suggested that free trade in beer ought to be introduced for a number of reasons, but partly simply because of an opposition to monopolies and a belief that markets simply reflect underlying desires of citizens.

The twentieth century saw increased regulation of pubs and the alcohol industry, particularly in response the First World War, when some were effectively taken into state ownership to ensure they were managed responsibly.  This can be seen as the ‘expansive’ period.

The Beer Orders of 1989 might be seen as the end of this period, heralding a period in which liberalisation of the alcohol industry was seen by many as an opportunity to regenerate cities damaged by wider economic and social policy.  Bologna in Birmingham and Madrid in Manchester, anyone…  Perhaps this ‘neoliberal’ period culminated with the 2003 Licensing Act that came into force in 2005, with its much-trumpeted (though perhaps exaggerated) idea of 24-hour drinking.

The Conservative Party in Opposition and in Government has been hostile to this Act – at least in rhetoric – promising to tear it up.  CafĂ© culture has not materialised, we are told, and therefore changes will have to be made.  Perhaps this is the end of neoliberalism?

However, the solution in reality has not been to ‘tear up’ the act but rather ‘rebalance’ it with a series of measures that might tax or restrict the late-night opening of licensed venues.  Instead, both governments have made ‘empowering’ people the centrepiece of their alcohol policy, through labelling of drinks (though this has never been enforced) and education campaigns, such as Units and Know Your Limits, Would You? and Change4Life.  As Hackley and others argued with respect to the 2007 Alcohol Strategy, the lion’s share of responsibility is placed on individuals, not the industry or the state.

This reflects a consistent ideological position that the motor for change is the individual, and government has limited power.  Individual bankers are to blame for the financial crisis (and hence the welcoming of James Crosby surrendering his knighthood), and a ‘minority’ of drinkers – whether under Labour or Coalition – are to blame for alcohol issues.  Government’s role is ‘to encourage, support and enable people to make better choices for themselves’, as the Coalition Agreement stated.

This lack of confidence or willingness to make government part of the solution is illustrated well by Theresa May’s general statement on antisocial behaviour from the beginning of the Coalition government:

For 13 years, politicians told us that the government had the answer; that the ASBO was the silver bullet that would cure all society’s ills.  It wasn’t.  Life is more complex than that.  There is no magic Whitehall lever we can pull simply to stop anti-social behaviour.  No magic button to press or tap to turn to stop the flow of misery.  The solution to your community’s problems will not come from officials sitting in the Home Office working on the latest national action plan.  They will come from the homes of our citizens, from the heads of our police officers, council employees and housing associations, and from the hearts of our social workers.  We will put power into the hands of our citizens….  And we expect everybody to take responsibility, take action, get involved, tell the police and the other agencies what’s going on, and hold them to account for what they do about it.

The tension with a public health approach to alcohol, for example, is striking.  The default position of public health is one that is population-based, looking at problems at a societal level.  This is the key reasoning behind minimum unit pricing (MUP).

MUP is one of the key measures noted by Davies as marking a break from the neoliberal past, as an active intervention.  However, consistent with neoliberalism are general attempts to change individuals’ behaviour without changing the broader structures, and then attempts targeted at specific individuals, such as Drinking Banning Orders (‘booze ASBOs’).

MUP, as portrayed by the government, is understood in precisely these terms.  Rather than being a population-wide measure, it is understood as a targeted attempt to tackle binge-drinking culture and affect the cheapest end of alcohol, meaning that  a ‘middle class family’ like David Cameron’s apparently won’t be affected – and if anything it will benefit them as it will be targeting ‘binge’ drinkers, whose alcohol is currently subsidised by ‘responsible’ drinkers’ potato purchases.

In a similar way, although ‘nudging’ is presented as a break with the past, it is difficult to see how it is inevitably associated with any single mentality of government.  Changing the design of bars, what’s on offer, or the glasses available might be ‘nudging’ and could be ‘expansive’ liberalism as it implies the state directly interfering in an individual’s decision-making.  On the other hand they wouldn’t be particularly new, with Mass Observation wondering about glass size and speed of drinking, and government in the nineteenth century wondering about bar design.

Moreover, these aren’t the sorts of interventions being suggested by the BIT.  Their preferred interventions are the wording and content of letters regarding tax returns or GP appointments and informing students how much their peers drink.  These are not fundamental breaks with neoliberal modes of governance – the social marketing on drinking can be seen as simply a refinement of the Units or Would You? campaigns.

So, for what it’s worth, I think we’re still living in a neoliberal age.  It’s hard to imagine a leading politician suggesting state ownership of pubs – and it’s even hard to imagine MUP being implemented.  The individual, for better or worse, remains the unit of governance, whether it’s in alcohol, higher education or social security policy.  Both left and right might agree that for better or worse Thatcher’s method was economics and the result was a change in the heart and soul of the British people, but for all that liberal governance remains an imperfect, unceasing project, and there will continue to be examples of neoliberal workarounds, where failing structures are left in place while attempts are made to reform individuals acting within them.

Sorry for all the paywalled Times references.  Lacking an online subscription, I actually bought it on Tuesday and read it cover to cover to get my money’s worth, so I’m slightly over-influenced by that.

* I know what I’m about to write is an oversimplification, and perhaps even a misrepresentation.  People like John Greenaway, Paul Jennings and James Nicholls (amongst others) would no doubt be able to rip it to shreds, and I’d welcome any criticism.  A conference presentation by Paul Jennings recently enlightened me about the extent of government involvement in the beer trade resulting from the 1904 licensing act, and how long the influence of this legislation could be felt.  Following ideas of class and carnivalesque, there’s always been a governmental interest in regulating release/drinking (my favourite example is always Pentheus in The Bacchae).  However, I think at the moment the idea of a broad picture is helpful, and there are patterns in terms of what is considered.