[Warning: this is one of those over-enthusiastic “I’ve just
read this totes amazeballs book” essay-length posts, so if you don’t want to
read credulous speculation look away now]
Sometimes you read something at the right time that helps
you see things from a different perspective. I’ve just finished reading “The
Utopia of Rules” by David Graeber (an anarchist anthropologist, or is it an
anthropologist anarchist?), a set of essays that together offers a way of
thinking about bureaucracy that made a lot of ‘care’ services’ behaviour make
sense to me. In my usual fashion, I’ll quote/paraphrase extensively, then try
to say why I think it’s relevant to the ways people with learning disabilities
and their families are so often (mis)treated. This post is organised according
to three of the maxims set out in the book.
Maxim 1: “The Iron
Law of Liberalism states that any market reform, any government initiative
intended to reduce red tape and promote market forces will have the ultimate
effect of increasing the total number of regulations, the total amount of
paperwork, and the total number of bureaucrats the government employs.”
David Graeber adopts a very broad historical context, but
from this come a few starting points that help to describe some of the growth
in (and characteristics of) modern bureaucracies. Bureaucratic corporate
culture, applied in the name of ‘efficiency’, has been designed to extract more
wealth in the form of short-term profit, with the following consequences:
1)
The executive class within public and private
sectors (now indistinguishable in terms of corporate culture), previously aligned
with the workers who actually made things or did things, have now become
realigned ‘upwards’ to the interests of ‘owners’/financiers.
2)
‘Shiny’ language: “It was a cultural
transformation. And it set the stage for the process whereby the bureaucratic
techniques (performance reviews, focus groups, time allocation surveys…)
developed in financial and corporate circles came to invade the rest of society
– education, science, government – and eventually, to pervade almost every
aspect of everyday life. One can best trace this process, perhaps, by following
its language. There is a peculiar idiom that first emerged in such circles,
full of bright, empty terms like vision, quality, stakeholder, leadership,
excellence, innovation, strategic goals or best practice.”
3)
Bullshit jobs: “This helps a phenomenon I have
written about elsewhere: the continual growth, in recent decades, of apparently
meaningless, make-work, ‘bullshit jobs’ – strategic vision coordinators, human
resources consultants, legal analysts, and the like - despite the fact that even those who hold
positions are half the time secretly convinced they contribute nothing to the
enterprise.”
4)
The increasingly bureaucratic ‘credentialisation’
of jobs in society: “One could repeat the story in field after field, from
nurses to art teachers, physical therapists to foreign policy consultants .
Almost every endeavour that used to be considered an art (best learned through
doing) now requires formal professional training and a certificate of
completion, and this seems to be happening, equally, in both the private and
public sectors...In theory they are meritocracies. In fact everyone knows the
system is compromised in a thousand different ways”.
5)
Audit culture: “The basic idea behind audit
culture is that in the absence of clear, ‘transparent’ criteria to understand
how people are going about their jobs, academia simply becomes a feudal system
based on arbitrary authority” [this is a discussion of Marilyn Strathern’s
analysis of audit culture in an academic department] “…Such reforms may aim to
eliminate arbitrary personal authority, but of course they never actually do.
Personal authority just jumps up a level, and becomes the ability to set the
rules aside in specific cases.”
Any of this sound familiar in health, social care,
education? Including:
·
The shiny, corporatized language (gotta get a
website, a logo, a hashtag: the NHS Improving Quality (NHS IQ, geddit?) funded
School for Health and Social Care Radicals, hashtag #TheEdge, motto “Rock the
boat and stay in it”, springs to mind) that bears no relation to the realities
of people using these services.
·
The transmutation of useful jobs (social worker,
nurse) into accretions of ever longer and more meaningless bullshit job titles
(fancy being a Senior Business Devlopment [sic] Consultant/Manager – Social Care
anyone? It‘s a current vacancy in Community Care).
·
Audits designed to show the organisation to best
advantage rather than gain honest ideas for how the organisation can do things
better (sorry, #innovate and #exnovate) – the NHS Friends and Family Test, for
example, compared to the honest feedback collected via Patient Opinion designed
to start a conversation.
·
The increased ‘outsourcing’ of bureaucracy to
people getting support, which at the same time requires ever more intrusive
bureaucratic structures of surveillance (the way that many organisations ‘do
personalisation’ is a prime example, with more and more bureaucratic
responsibility placed on people and families, yet accompanied by a heftier
apparatus of ‘monitoring’ and ‘audit’).
·
Within such ‘totalizing’ or ‘predatory’
bureaucracies (David Graeber’s terms), the increasing difficulty that care and
support workers, social workers and nurses have in doing their jobs ‘on the
side of’ people and families wanting support, rather than feeding the
bureaucracy (and colleagues further up the organisational hierarchy).
Maxim 2: “Always remember it’s
all ultimately about value (or: whenever you hear someone say that their
greatest value is rationality, they are just saying that because they don’t
want to admit to what their greatest value actually is)”
“We are speaking of a certain abstract ideal of how
bureaucratic systems should work, not the way they actually do. In reality,
bureaucracies are rarely neutral; they are almost always dominated by or favour
certain privileged groups…over others; and they invariably end up giving
administrators enormous individual personal power by producing rules so complex
and contradictory that they cannot possibly be followed as they stand.”
“Such institutions always create a culture of complicity.
It’s not just that some people get to break the rules – it’s that loyalty to
the organization is to some degree measured by one’s willingness to pretend
that this isn’t happening…What I am saying is that we are not just looking at a
double standard, but a particular kind of double standard typical of
bureaucratic systems everywhere. All bureaucracies are to a certain degree
utopian, in the sense that they propose an abstract ideal that real human beings
can never live up to.”
The human in ‘human services’ has been systematically exiled
in the name of avowedly impersonal bureaucracies. This is because impersonal
rules are fair, right, ensuring that inequalities wrought by all the ‘biases’
of human beings engaging with each other without these rules don’t happen? And
workers are trained so such a high standard now that support for people is
uniformly great? And all these professional standards and organisations sharing
best practice means that bad stuff is extremely rare, spotted quickly and dealt
with honestly with people with learning disabilities and families? Wrong, wrong
and wrong. There are still shocking inequities in the access of people with
learning disabilities and families to decent services and support. Highly
trained staff who are there to ‘help’, can treat people appallingly, with the
organisations they’re working in rarely held to any form of meaningful
accountability (heads may rock a little, but they rarely roll out of the boat).
Bureaucracies perform an ongoing con trick on people who
have to engage with them. They are explicitly designed to be inhuman, so that
actual people engaging with these bureaucracies are set up to fail. And people
administering bureaucracies still have as much arbitrary power as they ever
did, except that it is now cloaked and not to be challenged (except within the
nonsensical terms of the bureaucracy itself). And everyone knows this,
including (especially) people administering these bureaucracies, but there is a
collective complicity within bureaucracies that does not allow this fact to be
spoken. This leads to the self-referential piles of mendacious bullshit that
bureaucracies present to the world (and to each other) that bear no relation to
reality. Surely it’s only in such totalizing inhuman systems that people have
to be told to act with ‘candour’ or that we really need ‘empathy’ in the
workforce – ironically the solutions to these ‘problems’ are themselves highly
bureaucratic (more credentialized training, more leadership, more audits, more
hashtags and award ceremonies), meaning that they are more than likely doomed
to fail.
If you’re a person with learning disabilities or a family
member, you’re presented with an invidious ‘choice’ – try to play the
bureaucratic game which is stacked for you to fail (with any ‘win’ more or less
temporary), or challenge the terms on which the game is played and face the
consequences.
Maxim 3: “Do not underestimate
the importance of sheer physical violence”
David Graeber makes what seems to me to be a fundamental
point that, for them to ‘work’, bureaucracies need to be underpinned by the
(threat of) physical violence towards those who try to operate outside the
terms of the bureaucracy:
“Max Weber famously pointed out that a sovereign state’s
institutional representatives maintain a monopoly on the right of violence
within the state’s territory. Normally, this violence can only be exercised by
certain duly authorized officials (soldiers, police, jailers), or those
authorized by such officials (airport security, private guards…), and only in a
manner explicitly designated by law. But ultimately, sovereign power really is,
still, the right to brush such legalities aside, or to make them up as one goes
along.”
“One of the central arguments of this essay so far is that
structural violence creates lopsided structures of the imagination. Those on
the bottom of the heap have to spend a great deal of imaginative energy trying
to understand the social dynamics that surround them – including having to
imagine the perspectives of those on top – while the latter can wander around
largely oblivious to much of what is going on around them. That is, the powerless
not only end up doing most of the actual, physical labor required to keep
society running, they also do most of the interpretive labor as well.”
“Jim Cooper, a former LAPD officer turned sociologist, has
observed that the overwhelming majority of those who end up getting beaten up
or otherwise brutalized by police turn out to be innocent of any crime. ‘Cops
don’t beat up burglars’, he writes. The reason, he explained, is simple: the
one thing most guaranteed to provoke a violent reaction from police is a
challenge to their right to, as he puts it, ‘define the situation’…It only
makes sense then that bureaucratic violence should consist first and foremost
of attacks on those who insist on alternative schemas or interpretations.”
For me, this might be getting close to the heart of how
(why?) so many people with learning disabilities and their families (and other
disabled people too) are treated so appallingly and with such violence by
health and social care services supposedly there to help. This threat of violence
isn’t symbolic, it’s real, and violence is exercised – forcibly removed from
your home, killed by neglect, solitary confinement (sorry ‘seclusion’),
physical violence (sorry ‘restraint’), forced administration of powerful
tranquilising drugs, not to mention ways of keeping people in poverty and
unemployed (sorry ‘benefit sanctions’). Again, within bureaucratic service
systems this violence is never named for what it is, despite the obvious trauma
experienced by people and families who have been subjected to it and the
obvious fear of vengeance and reprisals at the hand of bureaucracies expressed
by so many families thinking of questioning any aspect of their support.
And the interpretive labour that people with learning
disabilities and families in particular have to engage in is prodigious and
exhausting . One of my nieces is a teenager with learning disabilities with a
line in quietly acerbic asides to accompany her general awesomeness. My sister
spends an inordinate amount of time and intellectual/emotional energy engaged
in exactly this interpretive labour with people in bureaucracies – how shall I
present myself, my daughter and my family? Competent, with it, but not so much
that people will say no support is needed? Wanting the best, but not pushy,
demanding or unrealistic? Middle class enough to do business with, but not
superior? Knowledgeable, but with due deference to professional expertise – and
definitely not one of those internet mums? And of course, endlessly patient, as
this interpretive labour only goes in one direction. Get to an appointment late
as a parent and that can have serious repercussions; but if the bureaucracy
forgets the appointment altogether you’ve got to suck it up, not complain, and
try and reschedule.
And challenging the right of bureaucracies to define the
situation, in any number of ways, can provoke the violence discussed earlier.
Perhaps a person with learning disabilities does not show due deference (or
simply doesn’t really care about) arbitrary and nonsensical rules and
regulations? Perhaps a parent goes so far as to point out that somewhere in the
bureaucratic machinery an error has been made and wants to complain or, even
worse, wants it put right? These are the points at which bureaucratic vengeance
or worse are likely to arise.
Can there be life
outside bureaucracy?
As David Graeber points out, the increasing stranglehold of
bureaucracy over all aspects of our lives has become almost total, such that
any alternative to bureaucratic ways of organising society is literally
impossible to imagine. Romantic appeals to a pre-bureaucratic era don’t cut
much ice either, as this was hardly a golden age of equality for people with
learning disabilities either. But I think there are a few grounds for hope.
The first is the JusticeforLB campaign, which among many
other things is fiercely antibureaucratic and, in David Graeber’s words, has
“the defiant insistence on acting as if one is already free”. The #JusticeforLB
campaign is constantly exposing the shoddy, rigged, inhuman structures of
structural violence that are bureaucracies, and insisting on the fundamental
importance of a shared humanity rather than efficient rules as the foundation
for the way we treat each other (I’m reminded of a couple of other dudes who were
no respecters of bureaucracy, Bill & Ted, and their society-shaping maxim
“Be excellent to each other”. Along with their other maxim, “And party on
dudes!” that’s pretty much all you need, really).
The second might seem a bit weird, but it’s human rights, and
the Human Rights Act in particular. The human rights contained within the Human
Rights Act seem to me to come from a space outside bureaucracy, and are not
themselves readily assimilable into bureaucratic algorithms for ‘correct’
behaviour. Most obviously, the structural violence of bureaucratic systems is
off the agenda. It is also freely acknowledged that the basic principles of the
human rights may, at times and for particular people, conflict with each other,
acknowledging that lives are messy and not to be bound into any set of
constraining rules. Sure, bureaucracies can and do grossly misdescribe what
they’re doing in terms of adherence to human rights. However, perhaps it’s no
accident that lawyers (no strangers to bureaucracy themselves, but trained in
arguing from first principles and applying these basic principles to individual
lives) have dealt some of the biggest blows to the violence enacted by
bureaucracies towards people with learning disabilities and their families,
using the principles in the Human Rights Act. The LBBill is coming from a
similar place, compared to the much more limited ambitions of the “No voice
unheard, no right ignored” consultation, which seems to me to be aiming to
inject a little more rightsiness into existing bureaucratic structures rather
than developing legal principles with which to challenge these structures.
Finally, I have hope in those professionals and
organisations that are trying to reconnect to the human, based on human rights
principles. Can organisations supporting people with learning disabilities and
families operate by engaging people honestly, as human beings, without the
threat of violence lurking behind inhuman rules that are impossible to fulfil? My
hopeful answer is yes.
Reference
Graeber, D. (2015). The
Utopia of Rules: On technology, stupidity, and the secret joys of bureaucracy.
Brooklyn: Melville House.
