Cutting free tuition and bursaries for student nurses seems to be a good candidate for the one of the worst social policy decisions of the decade…
The NHS is currently critically short of nurses, with 42 000 posts in England unfilled.
This seems to be due to a decision by the Tory party in 2015 to remove free tuition and bursaries for those undertaking nursing courses, requiring nursing students to take out loans to cover their fees and costs of living while studying.
It appears that the prospect of starting a nursing career up to £50K in debt has but people off applying for nursing in droves. Since 2016 nursing applications have dropped by one third, and they are down 40% among mature students.
There seems to be a direct correlation here between the removal of bursaries and people deciding to not do nursing courses, which makes sense given that nursing is a low paid, stressful and low status career: who would want to start out £50K in debt?
In 2015, it was projected that the policy would have saved £1 billion a year, but this is almost certainly not going to be the case as it is estimated that nearly 50% of loans to student nurses will be written off because they will never earn above the repayment threshold, and because of the requirement to hire nurses through more expensive agencies.
It is estimated that replacing agency nurses with regular full-time nurses would save the NHS £560 million a year.
Why did the Tories introduce this policy?
It could be due a total disconnect between elite Tories and the kinds of people doing nursing degrees. Most Tories will have no idea what it’s like living on marginal wages and the difference bursaries can make down at the bottom of the pay scale.
Or it might be ideological – deliberately done to put the NHS in crisis and make it more expensive to run, justifying (in a downward spiral) the further outsourcing and selling off for profit later. Tories don’t need it after all, they have private health care.
It can’t be due to any rational decision making as this policy clearly makes no financial sense on any level.
The British government recently announced an additional £100 million of funding to tackle chronic homelessness in Britain. Chronic homelessness means those sleeping rough on the streets, rather than much larger numbers of invisible homeless: consisting of people in temporary accommodation or sleeping on friends’ couches.
The additional funding will pay for a three pronged ‘attack’ on homelessness:
£50 million for houses to be built outside of London, for people currently ready to move on from hostels
£30 million for mental health support for those sleeping rough.
Further funding to help people move on from prison into secure accommodation.
There is also funding available to provide more information and support to help those on the streets navigate their way out of homelessness, as well as the promise of research into the nature and extent of LGBT homelessness, currently a very under-researched area.
How effective is this social policy likely to be in combating homelessness?
Probably highly ineffective…
That funding is over 10 years – to 2027. There are an estimated 4751 people currently sleeping rough on any given night. If you divide £100 million by that figure, and then by 10 (10 years), the government is only committing an additional £2000 per person per year to combating homelessness. This doesn’t sound like a huge amount of money compared to the cost of housing, for example.
We have to understand this ‘additional funding’ in the context of the wider Tory cuts since 2010 – which have been linked to the increase in homelessness this decade…. 169% increase since 2010.
Finally, this policy does nothing to combat the much more widespread problem of households living in temporary accommodation -of which there are nearly 80, 000, again a figure which has increased under the Tory government since 2010.
Maybe this is more about creating some positive news for the government rather than it being any serious attempt at combating homelessness.. £100 million is nice round, easy soundbite type of figure, yet in the grand scheme of what’s needed to tackle social problems, it is almost certainly insufficient to make a real difference to a significant number of people.
‘nudge politics’ involves governments implementing small social policy measures to help people make the ‘right decisions’. This post considers some of the pros and cons of this type of social policy agenda.
The idea behind ‘Nudge’ was that by exploiting traits of ‘human nature’ such as our tendencies to put of making decisions, or to give into peer pressure, it was possible to ‘nudge’ people into making certain decisions.
10 years on, it seems that government all over the world have applied ‘nudge theory’ to achieve their desired outcome. They have managed to implement some relatively ‘small scale’ social policies and make huge savings at little cost to the public purse.
In the U.K. for example, David Cameron set up the Behavourial Insights Team (or Nudge Unit) which seems to have had some remarkable successes. For example:
Reminder letters telling people that most of their neighbours have already paid their taxes have boosted tax receipts. This was designed to appeal to the ‘heard instinct’.
The unit boosted tax returns from the top 1% (those owing more than £30K) from 39% to 47%. To do so they changed their punitive letter to one reminding them of the good paying taxes can do.
Sending encouraging text messages to pupils resitting GCSEs has boosted exam results. This appeals to the well-recognised fact that people respond better to praise.
Sending text messages to jobseekers reminding them of job interviews signed off with ‘good luck’ has reduced the number of missed interviews.
As with so many public-policy initiatives these days, the Behavourial Insights Team is set up as a private venture, and it now makes its money selling its ‘nudge policy’ ideas to government departments around the world.
The Limitations of Nudge Politics
Methodologically speaking there are a at least three fairly standard problems:
Firstly, the UK’s nudge unit hasn’t been in place long enough to establish whether these are long-term, ’embedded success’.
Secondly, we don’t really know why ‘nudge actions’ work. The data suggests a correlation between small changes in how letters are worded and so on and behaviour, but we don’t really know the ‘why’ of what’s going on.
Thirdly, I’m fairly sure there aren’t that many controlled trials out there which have been done to really verify the success of some of these policies.
Theoretically there are also quite a few problems:
The book and the ‘team’ above both talk in terms of ‘nudging’ people into making the ‘right decisions’… but who decides what is right? This theory ignores questions of power.
It also could be used towards very negative ends… in fact I think we’ve already seen that with the whole Brexit and Trump votes….. I’m sure those campaigns used nudge theory to manipulate people’s voting outcomes. It doesn’t take a massive swing to alter political outcomes today after all!
Finally, I cannot see how you are going to be able to ‘nudge’ people into making drastic changes to save the planet for example: I can’t imagine the government changing the message on its next round of car tax renewal letters to include messages such as: ‘have you ever thought about giving up the car and just walking everywhere instead? If you did so, the planet might stand a chance of surviving!’.
Final thoughts: the age of the ‘nudge’?
I think this book and this type of ‘steering politics’ are very reflective of the age we live in. (The whole theory is kind of like a micro-version of Anthony Giddens’ ‘steering the juggernaut’ theory.) This is policy-set very much favoured to career politicians and bureaucrats who would rather focus on ‘pragmatic politics’. It’s kind of like what realism is to Marxism in criminology theory: not interested in the ‘big questions’.
I just cannot see how this kind of politics is going to help us move towards making the kind of drastic social changes that are probably going to be required to tackle the biggest problems of our times: global warming, militarism, inequality, refugees for example.
1 in 3 children in the U.K. is either overweight or obese by the time they leave primary school, with those from deprived areas twice as likely to be affected.
There are some pretty obvious downsides to childhood obesity to both the individual and society – such as the increased risk of obesity related illnesses such as diabetes, and estimated annual cost to the NHS of > £billion/ year.
The government today announced a set of measures designed to halve the number of children suffering from obesity by 2030, which included
A ban on the sale of energy drinks to children.
A uniform calorie labeling system to be introduced in all restaurants, cafes and takeaways.
Shops are to banned from displaying unhealthy food at checkouts and entrances
Shops are to banned from including unhealthy food in special offers.
Primary schools would be asked to introduce an “active mile” to encourage children to be more active, including daily running sessions and an emphasis on walking and cycling to school.
The plan forms the second chapter of the government’s childhood obesity strategy. The first chapter was criticized for being too weak when it was published two years ago.
Given the increase in childhood obesity, this seems to be like a timely intervention:
Arguments for banning advertising junk food to children
There is strong evidence that children who are more exposed to advertising are more likely to eat more junk food, which is a starting point argument for banning the ads.
Even if you argue that is is the parents’ responsibility to control what their kids eat, the fact that in reality, it is simply impossible for parents to regulate every aspect of their children’s lives: kids are going to go online and be exposed to whatever’s there: better that junk food adverts are not.
This move ‘fits into’ the general movement towards more child protection. In fact, I think it’s odd that junk food manufactures have been exempt from doing harm to children (by pushing their products onto them) for so long.
Those of a liberal persuasion would probably be against even more state intervention in the lives of families, however I personally don’t see these policies as ‘intervening’ in the lives of families, they are more about forcing companies to restrain their marketing of unhealthy food to children, so personally I can’t think of any decent arguments against these government policies…… suggestions welcome in the comments!
In the final section of Zimbardo and Coulombe’s ‘Man Disconnected’ the authors outline a few suggestions about how to combat the crisis faced by young men around the world. The post summarizes chapters 16-21).
Before reading this you might like to read the following posts:
Man Disconnected, which summarizes the evidence that young men are in crisis (chapters 1-7)
Zimbardo and Coulombe break down their solutions to focus on what governments, schools, parents, men, women and finally the media can do…
What governments can do:
Support the role of the father
Limit the use of endocrine-disruptors
Get more men into grade school teaching positions
Get junk food out of schools
Improve how schools prepare students for their lives ahead
What schools can do:
Teach life skills
Incorporate new technology for more interactive learning
Quash grade inflation
What parents can do:
Teach children to be resilient by letting them organise their own play and take risks
Give children responsibility for important tasks within the family
Encourage children to think about a future career, and to explore vocational options
Discussing taboo topics like sex
Fathers need to priorities fatherhood
Get children to track how much time they spend on different activities
What men can do:
Turn off the porn
Track your activity and consider what else you could be doing!
Make your bed (small accomplishments lead to bigger accomplishments)
Discover your inner power
Make a few female friends
Don’t call women sluts
Find a mentor, be a mentor
What women can do
Mothers and sisters basically need to encourage the strength and hardness associated with manhood, while having the depth of character and emotional sensitivity to help men become better communicators.
Don’t be promiscuous – because this just sends out the message to men that they will always have a string of available sexual partners
Choose a ‘good partner’ rather than a ‘flash partner’ – there are plenty of ‘good men’ (who want long term relationships) being overlooked because they are ‘drowned out’ on dating sites by better looking men who have no genuine interest in commitment.
Zimbardo’s final chapter is a brief one on what the media (especially the porn and gaming industries) can do to help stem the crisis of masculinity.
One person (probably among many others) that’s not happy about this is Russell Brand, who pointed out that yet again it’s the marginalised and powerless who are being made to suffer so that the elite can have a ‘jolly nice time’.
He outlines his views in this brief, 5 minute video clip:
One of this suggestions is that Slough Council should hand over one its buildings to SHOC ‘Slough Homeless Our Concern’, so at least there is some real, tangible, extra support being made available for the homeless in the area.
You can sign an online petition in support of the idea here>
Relevance to A level sociology
I thought this was a cheeky little example to highlight how the marginalised get treated in this country, also illustrates elements of the social construction of crime – in that ‘homelessness’ becomes more of a problem when the context (the impending wedding) approaches.
Also – here we have celebrity Russell Brand, a ‘moral entrepreneur’ spearheading a very specific, niche, social policy campaign (/suggested intervention) via his YouTube channel – there’s something very postmodern about all of this…
The Daily Mail and their Tory beneficiaries would have you think that the current crisis within the NHS are caused mainly by a combination of the following variables:
HOWEVER, this is not the case according to some more in-depth analysis by Ravi Jayaram, an NHS consultant (in The Guardian), who instead blames several years of chronic underfunding by the Tory government which have had the following effects:
Firstly, Primary Care services have been decimated by funding cuts, and as a result there are fewer GPs per patients, and so people feel they have to go to A and E rather than seeking help from their local GP.
Secondly, the recent conflict over Junior Doctors’ pay and the removal of the nurses bursary has left a sour note in the NHS, with those who are able to do so retiring early or leaving the country, meaning that the staff left behind struggle to provide safe and effective care.
Thirdly, whole wards of some hospitals have been closed by hospital trusts in order to stay in the black, meaning there is a decrease in supply.
NB – all of this has been going on while, as is well known, there is an increasing demand for NHS services by an ageing population!
And the deeper cause of all of this….well it’s a blinkered commitment to a neoliberal ideology which champions lower taxation and tight control on public spending….
In 2005 New Labour liberalised the gambling the laws, ending the ban on T.V. advertising, which is in line with neoliberal policies of decreasing state regulation of private companies.
12 years later and we have a situation where endless T.V. adverts glamorise gambling and hook new converts, and where online gambling companies such as 888 Sport and Paddy Power are targeting children with their online gambling games – exploiting a loophole in the law in which allows online games to advertise to children, but not casinos etc.
According to the industry’s own regulator, the Gambling Commission, around 450 000 children, or one in six of all those aged 11-15 now gamble at least once a week.
It seems that in this case, the right of gambling companies to make a profit trumps the well being of our children (*), and there’s also a nice example of Toxic Childhood here…. not only do our kids now have to deal with information overload, the contradictions of staying thin while being surrounded by junk and the pressures of over-testing, they’ve now got to deal with a potential life time of gambling addiction.
Stephen Hawking this week accused the Conservative government of damaging the NHS by slashing funding, weakening the health service though privatization, demoralizing staff by curbing pay and cutting social care support.
Hawking blamed a raft of policies pursued since 2010 by the coalition and then the Conservatives for enfeebling the NHS and leaving it unable to cope with the demands being placed on it.
“The crisis in the NHS has been caused by political decisions,” he said. “The political decisions include underfunding and cuts, privatising services, the public sector pay cap, the new contract imposed on the junior doctors and removal of the student nurses’ bursary.
Hawking also accused the Tories of ‘cherry picking evidence’ to back up their views that funding cuts were not damaging the NHS…
“When public figures abuse scientific argument, citing some studies but suppressing others, to justify policies that they want to implement for other reasons, it debases scientific culture…One consequence of this sort of behaviour is that it leads ordinary people not to trust science, at a time when scientific research and progress are more important than ever, given the challenges we face as a human race.”
Comments/ Application to Sociology
I thought the news item above was worth summarizing as it’s such a great example a critique of neoliberal social policy – Hawking basically picks up on all the three main aspects of neoliberal policy – deregulation, funding cuts and privatization.
The matter of ‘trust’ is also a very central concept in any sociology of the risk society – Hawking is saying that you can trust scientific research as long as you’re objective about it and take into account all of the data and (appropriately reviewed) studies on the topic in-hand – not enough people are saying this clearly enough, and I think it’s important as it’s a useful antidote to post-truth politics.
As to the credibility of science being undermined when politicians cherry-pick data, this is less likely to happen if more scientists like Hawking get involved in social policy discourse. I mean: who do you trust more: The health minister Jeremy Hunt telling you the NHS is doing great based on studies B, F, AND M, or someone like Hawking telling you that, yes studies B,F, and M tell suggest the NHS is doing OK, but if we also take into account studies A through Z, on balance the neoliberalism is screwing our public health services?
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