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How do we interpret the significance of living well with dementia?
Strange through it may seem, I have been most influenced in my philosophy of living better with dementia by the late Prof Ronald Dworkin who died in 2013 at the age of 81 (obituary here).
One recent campaign has the tagline ‘Right to know’ from the UK Alzheimer’s Society – about the right for you to know if you have dementia as a diagnosis, a right to treatment, and right to plan for the future.
I feel that people newly diagnosed with dementia have other rights too. I would say that, wouldn’t I. Above all, I feel that people who have received a diagnosis of dementia have a right to live well. This is truly a legal right, as this is not negotiable under the Universal Declaration of Human Rights. Recent case law, in the judgment from Lady Hale in R v Cheshire West and Chester Council (et al), re-emphasises that human rights are inalienable. And given that dementia is a disability under law, the right of that person with dementia is a right to dignity, reinforced by our universal human rights.
Focusing on a right to treatment further consolidates the biomedical model which I think is utterly unjustified. We have just seen the peak of one of the most successful campaigns ever mounted by Pharma and large charities for dementia to raise funds for pharmaceutical approaches to dementia. But at the expense of offering jam tomorrow there was very little on offer for people currently living well with dementia. The answer given to Helga Rohra by the World Dementia Envoy gave little in the way of concrete help for people currently trying to live well with dementia. And the ignorance of this is not benign – for the millions of dollars or pounds sterling spent on molecular biology and orphan drugs for dementia to meet the deadline of 2020, this amount of money is being taken out of the pot for developing the evidence base for and for strategies for living better with dementia in a non-pharmacological way.
Just a minute. Look at the evidence. The medications known as cholinesterase inhibitors are generally thought not to slow down the progression of Alzheimer’s disease in humans, even if they have a short valuable time window of use for symptomatic treatment In the UK, and across the world, there has been a drive for reducing the number of inappropriate prescriptions of antipsychotics for people living with dementia; there is now a growing consensus that where symptoms exist they often are due to a fundamental failure in communication with that person living with dementia, and often other therapeutic routes are much more suitable (such as psychological therapies).
The great FR Leavis, intensely under promoted at Cambridge, reminded us that criticism had to be free and flexible: and hence the famous description of the ideal critical debate as an ongoing process with no final answer: “This is so, isn’t it?” “Yes, but …”
Criticism of the English dementia policy may seem like criticism of senior clinicians, senior personnel in charities or senior politicians, but Leavis gives us a powerful reminder to stand up for what it is right. Surely, people living well with dementia have a right to comprehensive high quality dementia care and support? The evidence in support of multidisciplinary teams, including social work practitioners, speech therapists, doctors, cognitive neuropsychologists, occupational therapists, speech and language therapists, working to produce pro-active plans is now overwhelming. There is now increasing evidence that specialist nursing could prevent many acute admissions to secondary care.
As the late Ronald Dworkin asked us to consider, we might think about what makes an “interpretation” true. As Dworkin notes, psychoanalysts interpret dreams, and lawyers interpret contracts. I would go as far as to say clinicians, of various backgrounds, interpret whether a person presenting with a particular cluster of mainly psychological symptoms is presenting with a dementia. I don’t think the diagnosis of dementia is necessarily easy to make. Given that you’re giving a diagnosis of dementia not just to a person with possible dementia but also to his friends and family it is essential to get right; not to misdiagnose depression as dementia for example. My gut instinct is that doctors of all variety do their utmost to get this diagnosis correct. I think there is also a degree of interpretation in how much a person will successfully adapt to their diagnosis in taking an attitude of ‘living well’, or how they will put their faith in pharmacological treatments. The drugs do work for some people for part of the time after diagnosis, so their importance must not be diminished either. I think there is also a degree of interpretation of how disruptive a diagnosis of dementia might be for that person and his or her community.
Dworkin also notes you would be prone to sack a Judge who said, “I am not sure if this person is guilty or not guilty. I think he’s guilty, but you could probably find great many judges who finds the person not guilty.” It is possible that in the more complicated cases a Doctor might find a person living with dementia, another one not living with dementia. Dementia is presented as a definite diagnosis, a binary decision; but this would be to ignore that even the diagnostic criteria, such as the critical importance of memory (or not), has changed with time. Likewise, there has been a growing conflation of whether you fail a series of tests is the same thing as having a diagnostic label; see for example how some people recorded as having ‘delirium’ in the medical notes have in fact, strictly speaking, failed a specific set of screening tools.
But we can say that there are non-medical routes which are not an idle exercise but are of a person flowing from the diagnosis of probable dementia. This is there is much which can do to enhance the living environment of a person, whether a hospital ward, home or town. Or somebody can be directed towards advocates who can help persons with dementia communicate decisions. Or a person can be directed to inexpensive assistive technologies or lifestyle adjustments that can allow a person to live with dementia just like any other disability. This is framing long term care as living with a condition, rather than the single hit treatment.
Dignity, independence and a vast array of other values will, I feel, are a very necessary outcome of this more helpful approach to dementia. The person who has received a diagnosis of dementia is as much of a need of an acknowledgement of uncertainty as a water-tight explanation. The person who has received a diagnosis of dementia needs to be partnership with the people who wish to share that diagnosis with him or her.
I feel it is now time to unmask the medical professional who may simply be not be able to cope with this cultural shift. The medical profession does not know all the answers, nor indeed do all the people who’ve signed up to the Pharma script.
People who want to live better with dementia can be secure in the knowledge that that is their human right. They have a right to this solution, wherever it comes from.
Reference
Is there truth in interpretation? Prof Ronald Dworkin
What is justice if people don't understand it, and can't access it? The Goldsmiths 'Accessing Social Justice in Deprived Communities' Report 2012
This research was carried out at Goldsmiths, University of London, with funding from the Leverhulme Trust. The research team would like to express their appreciation of this funding that made the research possible.
For further details please contact: Marjorie Mayo, m.mayo@gold.ac.uk or Maria Dumas, m.dumas@gold.ac.uk
A copy of the full report, Accessing Social Justice in Deprived Communities, including an executive summary can be downloaded from: (click here)
(c) Goldsmiths, University of London 2012.
[This is a shortened version of the executive summary especially for this blogpost.]
Introduction
The research for this report has been undertaken at a critical time for Law Centres. When the research started, the previous government was promoting public sector modernisation with more marketised approaches to the provision of legal aid. By the time that the research was being concluded, these pressures were being increased even further – the Legal Aid Sentencing and Punishment of Offenders (LASPO) Bill was proposing to reduce the scope of Legal Aid from key aspects of employment, welfare benefits, debt, aspects of housing law, immigration and family law, along with legal aid for school exclusions, clinical negligence and personal injury cases. This would have serious consequences for the funding of Law Centres that provide such services. And the consequences would be devastating for those whom Law Centres serve, people in disadvantaged communities, who would be unable to access legal services by any other means.
Some Law Centres have also been facing cuts in funding from local authorities and other funders. As a result of all these pressures an estimated third of Law Centres are under serious threat of closure – at the very time that the number of people needing legal advice services has been increasing as a result of a combination of factors including high levels of unemployment, debt, public expenditure cuts and welfare reforms.
So how have Law Centres been coping with these increasing challenges? How have they been managing the pressures and the tensions – meeting the requirements of funding regimes that don’t fit with their clients’ needs, whilst holding on to their ethos and values, providing access to justice for all?
Background
The challenges from public service modernisation reforms
- The research found that New Labour reforms were believed to have:
- Underfunded Law Centres’ work with clients
- Put additional pressures on management systems and management committees
- Reduced the scope for public legal education
- Reduced the time available for outreach and community work
- Undermined Law Centres’ wider preventative and policy work (including taking test cases)
For Law Centre staff, there have been tensions as a result, holding onto professional values and identities whilst operating effectively in this more ‘business-like’ context. The research highlighted the importance to staff of:
- Giving each client the time they really needed whilst meeting targets for numbers of clients seen and cases closed
- Holding onto collaborative ways of working whilst managing competitive tendering processes effectively
- Working with increasing numbers of volunteers.
Methods
This research explored these questions. The team was based at Goldsmiths, University of London and independently funded by the Leverhulme Trust. The researchers carried out a survey of 107 staff and volunteers from 25 different Law Centres in England. In addition 112 interviews were carried out – exploring the views of local authorities, advice agencies and other legal aid providers as well as the views of Law Centre staff and volunteers.
Findings
There was widespread evidence of demoralisation as staff struggled to hold onto the Law Centres’ ethos, whilst becoming more business-like in the ways in which they operated. This was often exacerbated by lack of security, funding problems and the threat of further significant changes to Legal Aid. Several Law Centres had closed from lack of funding during the research and some of those interviewed were in the process of leaving their jobs in the Law Centres that remained, because of the pressures they were experiencing.
Despite the multiple challenges faced by Law Centres and their staff, the research encountered impressive levels of commitment. Many staff members have been working long hours and contributing unpaid overtime in order to keep services operating effectively for their clients – because they have been so committed to the importance of providing access to justice in disadvantaged communities.
The research also found positive examples of collaboration between Law Centres, local authorities and other agencies, where partnerships had formed to deliver joined up advices services and meet current challenges together. This type of strategy had multiple benefits including better mapping and targeting of provision, the ability to jointly attract funding, delivering complementary services more cost effectively, facilitating cross referrals and offering better promotion of services.
Response
Law Centres have been developing strategies in response to current challenges and exploring ways of maintaining services. These include:
- Charging some clients (although very few clients would be likely to be able to contribute significantly, especially if they were on benefits)
- Setting up trading arms, to cross subside legal aid work (although it could be challenging to compete with private firms for business in the current economic climate)
- Undertaking ‘no win, no fee’ work (although this might become seen as ‘ambulance chasing’)
These types of responses were being considered although each had its potential problems and limitations.
Particularly promising responses included the development of collaborative rather than competitive approaches, working with other advice agencies in partnership, along with local authorities, to provide a seamless service for clients, across a particular area, including in some instances the use of telephone and web based advice systems.
Conclusion
In summary, the research confirmed the value of Law Centres as well as the values of those who worked and volunteered within them. There was strong agreement on this across the spectrum by those who were interviewed, including local authority councillors and officers, solicitors in private practice providing pro bono legal advice and staff from a range of other advice agencies. As an advice worker concluded ‘I really don’t know what we’ll do if they (the Law Centre) don’t survive’. ‘Save our Law Centres, they are crucial’. What was clear from the interviews was the fundamental role that Law Centres can play, underpinning and supporting the work of individuals, communities and other agencies.
Despite their efforts to hone their business skills, develop new forms of income generation and attract new sources of funding and volunteers, Law Centres also need sustainable funding from public resources.
This research was carried out at Goldsmiths, University of London, with funding from the Leverhulme Trust. The research team would like to express their appreciation of this funding that made the research possible.
For further details please contact: Marjorie Mayo, m.mayo@gold.ac.uk or Maria Dumas, m.dumas@gold.ac.uk
A copy of the full report, Accessing Social Justice in Deprived Communities, including an executive summary can be downloaded from: www.gold.ac.uk/departments/pace
[Thank you very much to Matt Scott, a Community Researcher at Goldsmiths, for the information contained in this executive summary.]
Will opposites attract?
I am posting this following a recent tweet this afternoon. Incidentally, my article got a very hostile reception the first time around, Sundeep and Neil!
Lawyers in training often become bewildered as to how parts of their course ultimately gel together. This possibly contributes to their uncertainty in choosing which part of the law to specialise in. For example, how on earth does constitutional law, including the rule of law and human rights, relate to the different specialisms of law, such as immigration or housing? And what have they got to do with the big powerhouse corporate law firms, if anything?
A surprising fusion of these ingredients could hold the key to solving a different problem that has been vexing English and Welsh law for several decades, at least. That is, the issue of what to do about the provision of legal aid.
A community law centre, where the lawyer might examine a sensitive landlord-tenant dispute, may seem ‘worlds-apart’ from the work of a corporate lawyer, who may be advising on a multi-billion-pound, headline-grabbing deal. However, it is possible that these circles might mix more in future, due to the current circumstances.
Access to the law: back to the basic constitutional law
One of the very first things that law students focus on in their constitutional law courses is the ‘rule of law’. Indeed, the rule of law underpins the work of both ‘divisions’ of lawyers: the barristers and the solicitors.
In 1977, the influential political theorist Joseph Raz identified several principles that may be associated with the ‘rule of law’ in some (but not all) societies. Some of Raz’s principles include the fact that the courts should be accessible, i.e. no man should be denied justice, and that the principles of natural justice should be observed, particularly those concerning the right to a fair hearing.
And what of the actual reality of today, in England and Wales?
“The Government strongly believes that access to justice is a hallmark of a civilised society. The proposals set out in this consultation paper [on the reform of legal aid] represent a radical, wide-ranging and ambitious programme of reform which aims to ensure that legal aid is targeted to those who need it most, for the most serious cases in which legal advice or representation is justified.”
‘A brief history of legal aid’
Legal aid in England and Wales was originally established by the Legal Aid and Advice Act 1949, with the aim of providing equality of access and the right to representation before the law. The scope of legal matters covered in 1949 was very tightly drawn.
However, today legal aid in England and Wales costs the taxpayer £2bn a year – a higher per capita spend than anywhere else in the world. It is argued that the current scheme is available for a too wide a range of issues, including some which should not require any legal expertise to resolve. The provision of legal aid is now governed by the Access to Justice Act 1999 and supplementary legislation.
The possible effect of the proposed legal aid reforms
Many civil cases will no longer be eligible for legal aid, and fees paid in civil and family cases will be cut by 10% across the board, according to Ministry of Justice plans set out in the consultation paper, “Proposals for the Reform of Legal Aid in England and Wales”, released in November 2010.
The UK government has estimated that, under the plans, £350m will be saved from the Ministry of Justice’s budget by 2014/15, if its proposals are implemented in full.
Ken Clarke QC MP, the Secretary for State for Justice and Lord Chancellor, has said in an interview that,
‘I believe that the taxpayer should continue to provide legal aid to those who need it most and for serious issues. But the current system can encourage lengthy, acrimonious and sometimes unnecessary court proceedings, at taxpayers’ expense, which may not always ensure the best result for those involved. The proposals I have outlined suggest clear tough choices to ensure access to public funding in those cases that really require it, the protection of the most vulnerable in society and the efficient performance of the justice system.’
Reaction from the solicitors
The cut in legal aid may offend the rule of law. For example, the Law Society Chief Executive, Desmond Hudson, has warned that:
‘If the government persists with these proposals, it would represent a sharp break from the long-standing bipartisan consensus that effective access to justice is essential to underpin the rule of law. Legal aid clients are some of the most vulnerable in society and good legal representation where required is essential if they are to obtain justice. The Society will now consider the green paper in detail.’
The effect on the high street – the community law centres
‘Law Centres’ employ solicitors and case-workers who specialise in debt, discrimination, housing, employment, welfare benefit, community care, mental health law, and immigration and asylum law. Their initiatives are truly inspirational.
In an open letter dated October 2010, Julie Bishop, Director of the Law Centres Federation, provides a very interesting description of the impact that the financial recession – a possible driver in the need to cut costs in legal aid services – has had on the high street legal services:
“We serve 120,000 clients every year. The recession is hitting our clients hard. Already, the Employment Tribunals Service has recorded an increase from 10,800 to 19,000 in the number of cases related to unfair dismissal over the past year [October 2009-10]. ACAS has recorded a 13% increase in enquiries for conciliation services. Law Centres have experienced a 30% increase in clients assisted with employment and discrimination cases.”
An example of where the Law Centres have made a substantial impact is in Brent. Brent Community Law Centre stated that the cuts to legal aid will leave two options for those in poverty on Jobseeker’s Allowance: “a move from poverty to extreme poverty, or possession or eviction if they do not pay their rent.”
They cite that a single person living in a one-bed flat paying £180 per week will have to contribute £18 to the rent out of a weekly income of £65.45, leaving £47.45 for all other expenses including fuel. A separate (but linked issue) which compounds vulnerability is the proposed capping of housing benefit. It is estimated that this will cost claimants in Brent an average of £8,817,844 per year. This loss is to be shared among 1,988 claimants. If their rents are not reduced, they will have to pay £4,436 per household out of their own income. Currently, the Brent Law Centre is able to advise on this issue.
Brent Law Centre argues there will inevitably be far more possession cases in the county court because landlords, whether council or private, will bring court action for rent arrears. In addition, they believe that the impact on costs for other departments, such as social services and child protection need to be assessed.
Brent Law Centre, only through the goodwill of an army of unpaid volunteers, is currently able to provide legal advice and assistance for residents of Brent on a range of legal issues including education, employment, housing, immigration, mental health, public law and welfare benefits.
An unlikely solution?
It has not gone unnoticed that one of the effects of losing £350m from the existing £2.1bn budget may be to put corporate law firms under greater pressure to contribute to the provision of legal aid.
High profile pro-bono interventions by the household names in corporate law can become tied to big international events – such as helping out at the Sierra Leone war crimes tribunal (Weil Gotshal & Manges), or representing wounded soldiers in compensation cases against the Ministry of Defence (Hogan Lovells).
Nonetheless, doing pro bono has become attractive to graduates in an increasingly competitive job market, where law firms are keen to attract the best graduates, and graduates are keen to demonstrate their social awareness.
However, it is true that many newly-qualified graduates do contribute much time for free to the local community, often in very deprived areas, but find the work immensely fulfilling. This is despite the fact that their Managing Associates and Partners will not tolerate any compromises in their professional ‘day job’.
Who knows where this is heading?
The ideal outcome might be for a restructuring of legal aid services, such that the public and lawyers have a clear idea where the money is going to, and which enables fair access to legal services for the public. The crunch question inevitably becomes: “where this money is coming from, if it’s not the taxpayer?”
Brent Law Centre is just a single example of where professional lawyers give their skills free-of-charge for the benefit of the community, but it would be tragic to see a situation where lawyers cannot even do this because of the ‘system’.
It might be, even, that the corporate lawyers have a crucial part to play for the benefit of society, in contributing towards the maintenance of legal aid in the high street law.
Law centres and legal aid funding
This is not a headline you will normally see.
Firstly, I should like to acknowledge Krish, who tweets at @TheTCHawk, for providing the inspiration for this blogpost. He has recently written on his experience with the Citizens Advice Bureau for which he works.
Instead, I have been working in a famous law centre in London for the last few months. This has been an incredibly rewarding for me, as I am looking forward to studying law further in my LPC in January 2012. I have already spent four years in legal training, but one of the many things that I have learnt of some importance is that lawyers do not get emotional.
Once I was aghast when a law student tweeted at a friend of mine, “Is there a difference between a law centre and a CAB?” However, it was a perfectly reasonable question. As members of law centres, we must confront this issue of what we’re (=law centres) doing that’s different from CABs. Marketing professionals must have an understanding of the awareness of any particular brand, for example the CAB or the law centre, before proceeding to develop a marketing strategy. I feel that law centres will need to develop a professional marketing strategy to raise their awareness amongst the community and investors. In my belief, whilst the CABx brand is very strong indeed, perhaps for historical reasons, the ‘Law Centre brand’ is virtually non-existent in comparison. I would be interested to know whether this is borne out by any hard data.
I have been thinking about how my law centre, especially my area of welfare benefits advice for disabled citizens like me, can benefit from alternative sources of funding, like the Big Lottery Fund, but this fundamentally depends on what pitch I should make. Is it that we are any more central to the communiy than the CAB? Or is it that we have more specialist qualified legal advisors than the CAB who can act as advocates? Are any generalisations possible or warranted? Furthermore, legal aid funding affects private practice stakeholders, as well as legal centres and CABs, and market forces affect all three. For all stakeholders to benefit the public the most, which is their ultimate aim after all, they need to have a clear idea of their values and which services they’re providing, so that all stakeholders can achieve optimal market and strategic positioning in a crowded, funding-challenged, market, perhaps.
Whatever – I personally think all legal practitioners should be given support, acknowledging that funds are limited. but funding bodies will have to prioritise unfortunately. In fact, a focus on funding may have the beneficial effect of providing better precision to all stakeholders in their strategy and core competences of their legal services, whatever sector they are in. However, fundamentally, I most agree with the observation that, at this late stage, arguing over a sense of entitlement is totally unhelpful. It is desperately important that we fight until the end for our common purpose in protecting legal aid. I would find it very hard to support law centres if they wished to campaign at the expense of CABx or other stakeholders, but they should think about how they differ from other stakeholders when applying for London Borough grants for community investment or structural upkeep, I feel.
Immediately this throws you into the territory that, as a lawyer to-be one day hopefully, I am getting emotional. Worse than that, I am getting political. Of course, central to the whole debate, is access-to-law and the rule of law. The Law Society and Bar Council provide that the legal aid cuts offend this fundamental right, and indeed many blogposts and the Guardianistas have thus far pressed home this vital point. However, an issue that my colleagues in the Law Centre I work at feel enormous frustration at the fact we are simply unable to get our message across.
We have, as citizens of society, to acknowledge that no political party will be in power forever, and it is not impossible that this Bill will become repealed in time or amended drastically. I feel that all employees in all legal institutions should not feel frightened in giving a voice to the opinions of citizens wishing to protect legal aid, and should be allowed to express such opinions in this organisational change. As part of my MBA, I studied in enormous detail critical success factors for relatively-rapid organisational change like this in the public sector, and by far the most important issues are trust and openness in the followers (including legal professionals) in ensuring the change goes smoothly. This is in addition to the demanding structural changes which are necessitated in this reform.
An issue is that the Legal Aid and Sentencing Bill, as proposed, could have a selectively detrimental effect on certain groups of society, including the disabled. Many of us have been prone to defend our own patch, and there is somewhat an element of ‘divide-and-rule’ in the debate which has ensued. Yet again, whilst I find repugnant that welfare benefits legal advice is being cut at the expense of some other fields of law, I feel that we all should be pulling in the same direction of protecting all areas of law (but especially for the socially disadvantaged.) In other words, lawyers and bloggers appear to the outside world to be not “in it together“, talking at cross-purposes, and becoming constituted by tribalistic vocal subgroups which are easy to ‘defeat’ as a whole. Secondly, I believe, that there is an element of where looking forward to the holiday has become more exciting than the holiday itself. I had a feeling of this in our opposition to the Health and Social Care Bill, where Labour loved opposing, but were completely incompetent in articulating arguments about competition, quality, value and cost in the NHS. Indeed, further, like perhaps #OccupyLSX, the opposition for the left has become more exciting than the substantive points of the opposition itself; I do not deny the inspiring success of @SoundOffJustice, and others. In fact, I met them at the DODS meeting in September, and was overawed personally about how much passion they had put into their campaign.
Thirdly, some elements of the ‘progressive left’, for example the Liberal Democrats, perhaps could have been more articulate about the effects of the legal aid policy on children, families, and wellbeing, which are now central planks of Liberal Democrat policy. Fourthly, whatever the reasons for it, the Legal Services Commission has been criticised, and there is a huge amount which could be done to improve the legal aid funding mess which has developed for a number of decades, including the last Labour governments? Whilst I do not feel the need to be perjorative in quoting the “most expensive service in Europe” statistic, which is actually untrue, we do need to address how best to develop legal aid funding. Fifthly, and this is an economic and quasi-political argument, I am a Keynesian and I do not agree with the ‘maxing out the credit card analogy’, but likewise, albeit as an utilitarian, I do believe we have to prioritise given the deficit which has come around in a large part through recapitalising the banks in #gfc1 (a policy which I am still uncertain about).
Finally, we need to get people interested in this subject in the media. I don’t mean the Guardianistas necessarily, otherwise we’re preaching to the converted. Whilst Sepp Blatter and racism, superinjunctions, anonymised injunctions and Andy Marr, and the BBC’s Children in Need are very important issues, we could do with much more focused coverage and debate of the Legal Aid and Sentencing Bill. I think this is essential, as I bet my life that this will obtain Royal Assent without any difficulty in due course.
Tony Blair – The Journey : A failure to tackle inequality is a dangerous precedent for Labour
Actually, reading a book with such a careful index is like reading the abstract of a scientific paper. You can easily miss out the best bits, and get such a soupçon that you totally miss out on the real flavour. This could be the detriment of understanding Tony Blair, or possibly be an advantage. Despite my protestations which principally come from the Andrew Marr interview on the BBC, I went into the journey with an open mind, I hope..
The thing I instantly liked about “The Journey” is that it is easy to underestimate the nadir from which Labour actually came at the height of Margaret Thatcher’s popularity. I remember in my 20s what a disaster the Conservatives had become internally, and how they had virtually imploded on the issue of Europe (a topic which still threatens their infrastructure today). So, it was for me as Blair described indeed, having lived through the experience that Tony Blair talks about. I feel that I can actually empathise with his account, even though I have zero emotional intelligence, arguably, myself.
I had got used to defeat myself, I didn’t expect Blair to win, when I was at the age of 23, having experienced so many defeats in the past for me during the Thatcher generation. Quite early on in the book, Tony Blair seems to have an acknowledgement of not making his writing too self-congratulatory. Whether he’s actually succeeded on this I feel is a very tough call. His prosaic style varies from being candid emotionally, to being rather unemotional, as if he is talking in ‘legal speak’. However, the sense of excitement is there, as well as some sense of expectation management.
Some things in the book are pretty predictable. For example, the glowing reference of Alastair Campbell shines through. However, I find Blair very unclear on obvious certain failures of domestic policy. For example, I don’t feel that Tony Blair really tackles head-on the equality (inequality) divide. An epiphenomenon of this is that neither ‘poverty’ or ‘inequality’ are words are in the index, which I am sure that Tony Blair didn’t compile. There is an appearance of lip service to the Fabian Society, on a somewhat academic footing, with a surprising acknowledgement of Tony Benn and Tony Crossland at the University of Oxford. Blair seems to identify the problem:
“Once so altered, [Benn and Crossland] became staunch advocates of social action and of the party of the trade unions and the working class whose lives had to be liberated from the conditions of poor housing, poor education and poor health care.”
Critically, there is no explanation – or even an attempt at an explanation – of whether improvements in social indequality were achieved. However, it does seem that the culture of Blair, with the emphasis on September 11th, Gordon Brown, Alastair Campbell Iraq and Islam, seems to have somewhat overshadowed all this, and this really shows in the book. These topics have been described extensively elsewhere, so I won’t mention them. However what I did find incredibly interesting that a much publicised move was that of Gordon Brown to reduce the capital gains tax to a rate of 15%. Even Blair calls this move by Brown as heralded by politics than any real conviction, so the overwhelming impression for the reader like me is that Gordon Brown deliberately wished to court the city against any notion of anti-business rather than having thought carefully about the social and economic sequelae. Robert Peston has indeed cited this as a reason where the Blair/Brown axis failed, and I agree. Was the Labour government successful on this single issue, irrespective of Iraq or Afghanistan, more school and nurses, etc.? No.
This is a big deal, because parties tend to lose when they systematically alienate groups of people. I noticed this with Margaret Thatcher first of all, but I have latterly felt that Gordon Brown and Tony Blair did this with the working, middle and upper classes. “Somethings got to give” as Marilyn Monroe said, and it must before the next election, in addition to Labour formulating a coherent response to the effect of cuts on the economy and real people.
Is he a great leader? Well, he certainly achieved a lot, but it’s a moot point whether he made his domestic policies so toxic so as to make them rather uninspirational. Thankfully, there are other features of a good leader, such as intelligence, passion, focus, risk-taking and enthusiasm, and you can conceivably argue that Blair had all of these in abundance.