This week is the 200th anniversary of the Peterloo massacre. It was Britain’s Tiananmen Square, with pro-democracy demonstrators facing off against the military, on St Peter’s Fields in Manchester, 16th August 1819.

My great-great-great Grandfather was in the front line of the demonstrators and an eye witness to the violence.

If you know a lot about C19th British history, maybe from Fred Wharton’s A level class, you can skip the next bit.  

Harsh economic conditions and a political system that excluded most people in the North had created enthusiasm for political reform.   Parliament had passed the Corn Laws – protectionists legislation that benefited landowners at the expense of ordinary people.   

A mass meeting was held to hear radical orator Henry Hunt give a speech urging parliamentary reform, which attracted a crowd of nearly 80,000 people.   At the time only a tiny number of people, all men, could vote, and cities like Manchester had no MPs

The demonstration, while entirely peaceful, was seen as deeply threatening by the local magistrates, who had no official police force to keep order. The Terror of the French Revolution and the subsequent Napoleonic wars had scared the English ruling classes beyond belief and demonstration of this size terrified the local magistrates. Fearing a revolution, local magistrates ordered the 15th Hussars to charge the crowd forcing them to disperse, killing 18 and injuring nearly 700.

The impact of the Hussar charge was huge.  The incident was nicknamed Peterloo, after the battle of Waterloo.   The campaign for electoral reform was strengthened hugely, and reform of the police followed shortly after.

Percy Bysshe Shelley immortalised events in his poem Masque of Anarchy, where he describes Tory leader Viscount Castlereagh and the Manchester magistrates in these bleak terms:

I met Murder on the way –
He had a mask like Castlereagh –
Very smooth he looked, yet grim;
Seven blood-hounds followed him:

My ancestor, Thomas Chadwick, was in the front ranks of the Chartists on the day, and was an eye witness to events. History books recall Thomas as a mill owner, but I think this is a bit overstated.  He came from a family of weavers, and his mill probably only had a few looms run by family members.  His descendant Robert Chadwick would go on to become a large scale mill owner, and by all accounts a proper bastard. Robert married into the Staffordshire branch of the Chadwick family in order to gentrify himself. Another relative, Andrew Chadwick, was a slum landlord, who died fabulously wealthy. Thomas is my great-great-great Grandfather.

His brother James’ best friend was next to him, and was killed in the Dragoon charge.  The next day he wrote to his brother and described the events.  His description contains one of the most memorable lines ever written about Peterloo:

“an inhuman outrage committed on an unarmed, peaceful assembly.”

I was able to secure a copy of the letter in it’s entirety from the Rochdale archives.

Matching the letter to the list of victims I think he is describing the death of William Bradshaw, who was shot with a musket.

The significance of letters like this was crucial to the way Peterloo was perceived. The magistrates fought hard to get their version of events across, and newspapers like the Manchester Mercury were happy to oblige, praising “the necessary ardour of the troops in the discharge of their duty”, and blaming the radical orator Henry Hunt, who deserved “the deep and lasting execrations of many a sorrowing family”. 

The Times however went with the account of a Manchester businessman John Edward Taylor, which appeared on their front page on August 18th 1819

Taylor went on to found the Manchester Guardian as a direct response to Peterloo.

The Press condemnation, and the impact of letters like Thomas Chadwick’s had a profound effect. EP Thompson wrote “Never since Peterloo has authority dared to use equal force against a peaceful British crowd.”

Tiananmen Square by contrast did not prove to be decisive in changing Chinese history despite the stark image of the protestor facing down the tanks:

The true nature of events at Tiananmen Square are still disputed, however it is likely that nearly 10,000 were killed by 27 Army Group, according to a British Diplomatic cable:

It would be great to think that modern events would have more Thomas Chadwick’s recording their accounts, which would make it easier for the truth to get out. Instead it is easier for people who want to create a counter-narrative to spread disinformation and for Government’s to control the flow of information.

It would be great to think that current events in Hong Kong would have a better outcome than Tiananmen, but looking at troops massing at the border I am doubtful that is the case

Chadwick History Bit

For those of you interested in Chadwick family history this is my Grandfather, Robert:

My grandfathers grandfather was George Chadwick of Prestwich Manchester, baptised St Marys Prestwich 12/7/1807, married and buried All Saint Stand. His father was Thomas Chadwick, baptised 27/6/1766, St Marys Prestwich, the witness to the Peterloo massacre.

Thomas’ mother was called Alice, and his father was Samuel. Samuel was baptised St Chads Rochdale 24/4/1721, married Sarah Lock, 11/9/1757. His father was Robert.

At some point in the C17th my family moved from Rochdale to Prestwich. The last family member to live in Rochdale was Robert or Roberte Chadwick. The problem is that there are so many Robert(e) Chadwicks in Rochdale in the C17th that it’s hard to work out which one. There is a Roberte Chadwick who married a Dibrah Healey, but I think that the last Rochdale Chadwick is a generation older.

Working out why the family moved is equally hard. My best guess is that after the English Civil War Colonel Lewis (Louis) Chadwick, a hero of the New Model Army, moved to Lancashire. He was from the more aristocratic Staffordshire branch of the Chadwicks, but married into the Lancashire branch, gaining land.

This would make my family Roundheads; Puritans or Presbyterians. It does stick out that my family seem to have a rather limited choice of names; lots of Roberts, Andrews and Johns, which continues to this day. This is a feature of puritan families. We also have in the family tree a female relative called Silence Chadwick, which is about as Puritan as you can get.

My guess is that we were a fairly austere puritan family working in the cloth trades, probably as craftsmen working from home, who moved to Prestwich following Lewis Chadwick and his son John, who also served with distinction under Cromwell. A century later the black sheep of the family Thomas Chadwick, joined the Princes Manchester Regiment to fight for Bonnie Prince Charlie, for which he was hung drawn and quartered at Tyburn. Accounts at the time stress the pious protestantism of his family, and their aversion to popery.

Getting much further back from the mid-C17th is a tricky task, give the numbers of Robert Chadwicks in Rochdale. In the C19th Robert Chadwick, the horrible mill owner, had a number of his poorer ancestors dug up and re-buried in his new family vault, in order to disguise his humble origins. Without their grave stones to act as a cross reference we have little that allows us to work out which Robert Chadwick is our ancestor.

https://en.wikisource.org/wiki/UK_cable_on_Tiananmen_Square_Massacre

Two sharply contrasting policy announcements from the two major parties over the last couple of weeks, but equally frustrating.

First up was BoJo, with an announcement that he will prioritise funding for health and social care:

Next up was Shadow Chancellor with an announcement about ending public sector outsourcing:

There is of course one policy that would address both sets of policy issues:

Bring care homes back into public ownership.

Frankly this makes a lot more sense than bringing school catering contracts back in house. Delivering health and social care is a core competency of the public sector. It’s bloody good at it, and operates the largest health care organisation in the world. Schools are good at teaching, but mass catering isn’t really one of their core skills. It’s something that the private sector does much better.

[As a side note – lots of Local Authorities – many of them old Labour operated race and gender bars in Council employment well into the C21st. The most highly paid manual jobs were reserved for white men. Women and non-white workers were paid much less. Councils face huge bills for discrimination – Birmingham Council will spend more than £1bn on equal pay claims. It was easier to outsource these jobs to different providers]

If you don’t mind I’m going to shift between talking about policy and talking about economics. Health care is provided or commissioned by the NHS and is free at the point of use. Social care is means tested, and is the responsibility of the individual to look after themselves. This distinction goes back to the establishment of the NHS in the 1940s.

Where it gets complex is NHS Continuing care, where the individual has social care needs which are contingent on a healthcare condition, for example someone who has dementia. If you aren’t eligible for NHS continuing care but you are in a Nursing home you can be asked to pay for the social care costs. This is what BoJo is referring to in his Express article. There is a perception that having to sell property assets to pay for social care rather than handing them down to your children is an affront to people’s rights to inherit wealth. If you are reading this in Scotland social care in residential homes is free, although I think that money would have been much better spent tackling chronic ill health and falling life expectancy 

Before we use this definition to start and look at some statistics about care it is important to acknowledge that an enormous amount of caring takes place within families, and isn’t recognised in the statistics. As services have shrunk in the age of austerity so the amount of unpaid caring has increased.

The number of local authority residential care places peaked in 1984. Councils provided 144,564 places, the private sector provided 66,700 places and the voluntary sector 42,704. Although the extent of private sector provision was low, it was increasing rapidly – in 1980 it had only been 37,177.

By 2017, Local Authorities provision had shrunk to 19,200 places, the voluntary sector was roughly the same – 44,600, while private sector provision had soared to 179,000 places

Some of this was due to the Private Sector building more homes, while Councils closed them. Durham County Council closed it’s last remaining care homes, including Chevely House in Belmont a few years ago, claiming that the cost per bed £918 per week per bed for Council run homes compared to £474 it paid to the Private Sector.

By comparison there are just over 200,000 nursing home beds. The average cost for a care home bed is just over £600 per week, the average cost of nursing care just over £800

Demand is growing as the number of over-65s increases, and even though people increasingly prefer to be cared for at home we are close to the point where there are more people who want/need residential care than there are beds. This has huge implications for the NHS were the main reason for a delayed discharge of care is the lack of a suitable residential placement. 

But lots of the shift was pure outsourcing. Council homes were handed over to the private sector who ran them at a profit, and at a lower cost.

It might be helpful to explain my own perspective here. I did lots of work on older people’s care when I was a PCT CEO. The NHS had inherited a massive mess from the outgoing Conservative administration. They had been encouraging the NHS to reduce the number of cases funded through continuing care in order to force more people to meet their own costs.

If you are already familiar with the history of continuing care legislation you can skip the next bit, as it deals with shifts in Government policy over the last decade or 2.

The Thatcher government were keen to change the original definition of health and social care contained in the 1946 Act in order to reduce the amount of care which was free at the point of use, and increase the amount that was means tested. This led to the 1990 Health Service and Community Care Act, and in particular a rather awful policy document issued by the NHS Management Executive – HSG (92) 50:“Local Authority Contracts for Residential and Nursing Home Care: NHS Related Aspects”

HSG (92) 50 starts with the ominous sentence:

“The original distinction between health and social care contained in the 1946 Act had been changed by the 1990 Health Service and Community Care Act” .

It went on

“The local authority is responsible for purchasing services to meet the general nursing care needs of that person, including the cost of incontinence services (eg laundry) and those incontinence and nursing supplies which are not available on NHS prescription. Health authorities will be responsible for purchasing, within the resources available and in line with their priorities, physiotherapy, chiropody and speech and language therapy, with the appropriate equipment, and the provision of specialist nursing advice, eg continence advice and stoma care, for those people placed in nursing homes by local authorities with the consent of a DHA”

This redefinition of nursing care shifted costs from the NHS to the individual because Local Authority care was means tested. If you really want to hate the Tories for doing bad things to the NHS hate them for this.

HSG (95) 8; LAC (95) 5) made this clearer:

“Many people regard care in a Nursing Home as health care, and therefore the purchasing responsibility of the NHS. However, under the NHS and Community Care Act, Social Services were given a new responsibility for purchasing Nursing Home beds. As with the previous arrangement through the Department of Social Security this is subject to a means test. The regulations governing this are laid down nationally”

If you didn’t work in the NHS in the last days of the Tories you have no idea of the tyranny of Health Service Guidance and Health Service Circulars (HSG and HSC) often issued more than once a day by the Health Service Executive. The vast expansion of NHS bureaucracy under Thatcher, then Major had spawned the HSE housed in a purpose built impregnable management fortress near the Leeds ring road:

If there is one thing to praise the Blair Government for it did at least get rid of the Health Service Executive, and limit the number of HSCs that could be issued.

The continuing care rules were legally challenged in R. v. North and East Devon Health Authority, ex parte Coughlan, a landmark judgement which had forced the NHS to accept liability for a large number of continuing care cases.

Justice Hidden, in his judgement made the following ruling:

“I conclude that nursing is “health care” and can never be “social care” and that ….. HSG (95) 8 did not make any change to any NHS responsibility for health care services including nursing”.

In this context I was a newly appointed PCT CEO charged with sorting out the impact of this judgement on local patients.

Redcar and Cleveland Council still had a mixed economy. There were large Council owned Care Homes across the Borough, mixed in with private provision. We had continual battles with the private home owners, and kept a common line over costs:

https://www.thenorthernecho.co.uk/news/6973452.cash-and-ideas-may-keep-nursing-home-open/

While all of this was going on the Council was closing some of it’s own residential homes, moving patients into the private sector and replacing them with sheltered housing or specialist dementia care.

https://www.gazettelive.co.uk/news/local-news/redcar-cleveland-care-homes-close-3708757

My experiences with the care home market in Redcar and Cleveland left me with a profound belief that models of service provision based on outsourcing everything don’t work. In a key market like care provision the public sector should retain their own provision, even in a mixed market, in order to be able to shape market provision.

As a side note to this when we were reviewing patients for eligibility I came across an individual who had been allowed to move into older people’s residential care in his mid-50s because he was mates with the Councillor who chaired Social Services committee. For my generation a moving into residential care seems like a terrible way to live, clearly not for some!

Now that we have established the policy/legal context lets look at the private sector market structure.

The 4 largest providers have only 15% of the market between them: Four Seasons (4.9%), Bupa Care Homes (4.7%), Barchester Healthcare (2.8%) and HC-One (2.4%). The top 25 provides have 30% of the market. Small and medium sized providers still have lots and lots of the market. HC-One are in the process of aquiring BUPAs business, making them the single largest provider. The majority of companies in the market have less than 3 homes.

This would indicate that there are few economies of scale, and the cost base of care homes is driven by people costs – the number of staff needed to cover care rotas. At the moment staffing costs are 57.5% of total costs across the sector, and in order to maintain profit homes need to reduce the percentage of their income which goes out in wages. The problem of costs is linked inextricably with high staff turnover, as high as 30% of staff per year in some regions. The industry has a high level of immigrant employees, and the hostility to immigration over the last decade has made staffing problems worse.

As well as these direct care costs there are significant costs associated with the purchase or construction of buildings and meeting Care Standards Commission standards. These costs are typically funded through borrowing, and the whole industry has high levels of debt. The largest providers have high levels of Private Equity debt.

It was this kind of financing crisis which brought down the Southern Cross, the then largest care home provider in 2011. Things improved briefly, but a similar financing crisis forced Allied Health care into administration in December last year, and Four Seasons into administration 4 months later. There have been similar, smaller regional collapses on a regular basis.

These companies have 2 main customers; those funded by Local authorities, those funding their own care. Local Authorities have a lot more purchasing power than private funders, and can negotiate a much better price, typically 40% lower. Roughly 60% of customers are LA funded. The bigger chains of care homes have much higher proportions of LA funded clients. Smaller, privately owned homes have much higher proportions of private payers. Homes with higher proportions of private payers are much more profitable, and are concentrated in more affluent areas. The bigger chains have higher numbers of LA funded clients because they offer a more stable and predictable source of income which their investors like

This is one of the commercial factors that drives BoJos policy – not only are some people having to fund their own care, but there is a perception that by paying higher prices they are subsidising other residents. In reality private paying clients tend to live in homes with low levels of Council funded residents and vice versa.

The Competition and Markets Authority investigated the care home market last year to investigate cross-subsidisation, although they concluded that the problem was lack of funding into Local authorities rather than private funders being ripped off. This reflects the reduction in fees paid by Local Authorities – since 2010 Local Authority rates per bed have fallen by 6% in real terms.

There is a starct contrast betwen the golden age of social care funding increase under the last Labour Government – peaking at 4% above inflation in 2006/7, and a rea terms cut in central government funding for social care

The Coalition Government’s 2010 Comprehensive Spending Review, local
government spending fell by 26% in real terms by 2014/15, although the fall was mitigated to 14% once council tax increases and other factors were taken into account. 

Spending on care by local authorities (including funds transferred from the NHS through the Better Care Fund) fell by 5.3% in real terms between 2010-11 and 2016-17 despite rising demand and a more acute illnesses.

As fees fell so did the profits of care home companies. EBITDA across the sector has fallen from 30%+ 10 years ago to 20% now. This still seems pretty generous but when the costs of finance are taken out there isn;t much profit left

Despite the Coughlan judgement people with conditions like Dementia are still liable to pay for their own social care costs until their assets fall below a particular level.  At the moment the floor is £23,500.  The last Conservative Manifesto Conservative proposed raising that floor to £100,000 and introduce a life time cap of £72,000.   For the first time in the case of people being cared for in their own home, that calculation includes the value of their house.  This was attacked by the Labour Party as “the Dementia Tax”forcing a Government U-Turn.   Crazy that a supposed left wing Labour leadership would defend inherited wealth in this way.

This was a massively expensive promise, costing nearly £15bn over the next decade.  It would nearly as expensive as implementing a Scottish style free social care model.

Sadly this bit of politicking has made the debate harder – the system isn’t sustainable without additional resources.  Because older people are richer than working age adults any policy which increases tax payer funding for social care in highly regressive.   Any policy changes are expensive  – £20 per week extra in costs per person equals £1bn a year

The current generation of older people have large amounts of unearned wealth generated by the property market, and the fairest way to fund the increase in social care funding is using this accumulated wealth.  We would still need additional taxpayer funding, but by asking older people to contribute some of the wealth tied up in their properties we would make the burden on current taxpayers (most of whom don’t have the same level of accumulated property wealth 

But extra funding doesn’t answer all of the problems.   It will help raise the prices homes can charge, which will stabilise the sector.

In order to expand supply the state should start and by up distressed chains of care homes. The big cost that is sinking homes is debt. The Government can refinance this debt at a heavy discount.   Once the state is actively playing in the market it can start and expand it’s own provision taking advantage of cheap Government borrowing.   As an active participant in the market it can start and shape future provision and address market failure.  

The state can also give care home workers more chances for career progression, from caring into Nursing for example, making care work more attractive as a career.   

The UK also has a shortage of housing with care – effectively retirement communities.   Only 0.6 per cent of over 65s live in housing with care, 10 times less than in more mature retirement housing markets such as the USA and Australia, where over 5 per cent of over 65s live in housing with care. Obviously the climate in Florida is more attractive than Saltburn or Seaham, but areas like this with cheap land would be obvious areas to expand purpose built retirement communities.   At the moment the way that Local Authorities and the NHS are funded mean that no-one would welcome such a development in their local area

This gets us to the existential problem. Without an expansion of supply the sector we will start and run out of beds in the next 5 years.   In some parts of the country it is a lot less than that, and residents will have to move a further and further away to find a place. This is the urgent problem that needs Government to solve, not protecting inherited wealth, or re-nationalising dinner ladies.

https://www.theguardian.com/politics/2019/jul/20/labour-pledges-to-push-councils-into-taking-back-local-services

https://www.laingbuisson.com/wp-content/uploads/2016/06/Care_OlderPeople_27ed_Bro_WEB.pdf

https://www.dailymail.co.uk/news/article-7254331/Two-homes-proud-owners-sold-pay-crippling-dementia-care-costs.html

https://www.thenorthernecho.co.uk/news/11134577.durham-county-councils-five-remaining-residential-homes-in-stanhope-belmont-ferryhill-peterlee-and-chester-le-street-recommended-for-closure/

https://www.grantthornton.co.uk/globalassets/1.-member-firms/united-kingdom/pdf/documents/care-homes-for-the-elderly-where-are-we-now.pdf

We are living through a golden age of near full employment according to the Department of Work and Pensions and the Office of National Statistics.

Despite a slow growing economy and low levels of business investment unemployment is back to levels not seen since the 1970s.

I have mixed views about this. I do think that there are lots of good things about the UK labour market. The combination of the National Minimum Wage, Tax Credits, and increased workplace protections have made the labour market more flexible, drawing in more workers. That flexibility has benefitted employers, who have hired more people.

But there is something going on that makes me sceptical. I remember what 1970s full employment was like and this isn’t it.

Some of this scepticism is because I think that the Labour Force Survey isn’t really up to the job of measuring unemployment in a complex labour market with high levels of self employment, zero hours contracts and part time working.

This was one of the first blogs I ever wrote:

https://jon-chadwick.com/2017/03/18/unemployments-rising-in-the-chigley-end-of-town/

While employment has been rising, so has the number of companies. The number of new businesses created in the UK between 2007–08 and 2015–16 grew from 3.4m to 5.6m, higher than in any other OECD country, The number of businesses with employees grew much slowly than the number of sole traders. The number of employees grew by 15%, while self-employment (including those operating as a sole trader or as a partner in a partnership) grew by 25%..

We can see the same effect more dramatically by comparing the growth of companies with employees and the growth of companies without employees:

The growth in business ownership is driven entirely by sole traders, and the number of foreign-born sole traders more than doubled between 2007–08 and 2013–14, accounting for one-third of net growth in the sole trader population over that period. There increase accelerates after the credit crunch.

There are some other things that we know about sole traders.

Sole traders on the whole have very low incomes. The mean annual taxable income (from all sources) of sole traders was £21,000 in 2015–16 (£10,000 below that of employees) median income was just £13,000, with 36% (1.5 million people) earning below £10,000. The income sole traders derive from their business (profit) is even lower on average (£12,100) and has fallen by £3,300 (21%) in real terms since 2007–08

There is also a very high turnover of business start up and closure. Between 2014–15 and 2015–16, the sole trader number of sole trader businesses grew by almost 70,000, but this was 650,000 start ups and 580,000 closures, with sole traders moving in and out of business ownership.

20% of newly set-up sole traders are not trading after their first year; 60% have ceased trading by year 5 and 80% have ceased after 12 years.

The growth in sole trader self employment co-incides with the long term decline in UK productivity since the credit crunch, a trend that has got worse since the Brexit vote. Business investment is low, productivity growth is low, wages are low, self employment is high

The UK definitely has a “long tail” of unproductive companies, much longer than Germany and France. The Bank of England regularly identifies the long tail as the main reason for UK’s poor record on productivity

Sole trader businesses typically are low profit/low investment businesses. 1 million sole traders (23% of the total) had total business costs below £1,000 in 2015–16, 2 million had business costs below £10,000. 300,000 had no business costs at all. Low investment, low productivity, low profit.

It could be that low interests and a willingness to live on very low wages, supplemented by tax credits, has allowed “zombie” businesses which make no money to survive, unproductive.

It is also possible that productivity is a misleading measure – craft products. If all of the sole traders were running artisanal bakerys, making craft gin or small batch cheeses then productivity would be falling but only because that is what customers want. But this doesn’t match with the low investment, low profit model.

The final thing we know is that the typical sole trader is an older man. Some of these are white collar workers laid off in the credit crunch who have returned to their previous industries as self employed consultants. Others are people forced into fake self employment in the gig economy by employers trying to circumvent the National Minimum Wage.

But some of this is however is the result of the Department of Work and Pensions encouraging people into fake self employment.

For someone who has paid their stamp you are entitled to 6 months of Job Seekers Allowance. JSA is a non-means tested benefit worth £73.10 a week. Once the 6 months are over JSA ends, and instead you go onto Income Support, a means tested benefit. For people with savings or a redundancy payment Income Support pays no money, but you are still required to go through the hassle of regular interviews and job applications.

Job Centre Plus has any easy solution for people in this conundrum. Register a business with Companies House and sign up for New Enterprise Allowance Scheme. NEAS pays a non-means tested benefit worth £1,274 over 26 weeks, just for completing a business plan. This puts you back onto benefits, and gets rid of the hassle of interviews and job applications.

After Ian Duncan Smith made such a big fuss over closing apparent benefit loopholes it is rather suspicious that this one was allowed to remain open, particularly as it has the effect of reducing unemployment.

What’s even more suspicious is that since 2010 the number of companies struck off the register by companies house has acce

OK. It’s not really suspicious. It’s a deliberate manipulation of unemployment statistics.

https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/ukproductivityintroduction/januarytomarch2019

https://www.ft.com/content/b6513260-b5b2-11e7-a398-73d59db9e399

https://researchbriefings.files.parliament.uk/documents/SN06152/SN06152.pdf

Anne Widdecombe announced her arrival in the European Parliament this week with a speech that made a spectacularly ill judged comparison with slavery.

Widdecombe’s views on slavery, the British Empire and the last few hundred years of British history maybe eccentric and unpleasant, but she isn’t the only person with crazy views about Empire.

I learnt about the abolition of slavery at school.

It was a pretty uplifting story, that most people will be familiar with.   William Wilberforce established the Committee for the Abolition of the Slave Trade in 1787, whose campaign led to the 1807 Abolition Act, and the 1833 Anti-Slavery Act.  The campaign was largely led by Quakers, and was helped by Josiah Wedgewood who produced a popular medallion with the legend “Am I not a man and a brother”.

A plucky campaign by the new emerging liberal middle classes brought about a change in the law, establishing a tradition of liberal middle class progressive activism that exists to this day.

I started to ponder this narrative after I read Ibram X Kendi’s masterpeice Stamped from the Beginning: The Definitive History of Racist Ideas in America.  If you haven’t read it, then read it. Now.

Reading the book made something stick in my mind, a detail I had noticed before but never really thought about.   Shakespeare’s Othello features a black lead character, a free black lead character.   Although the action takes place in Venice Shakespeare never has to explain to the audience why Othello is free, and of high status, and not a slave.

Which made me think that there were black people in Tudor London, but that they weren’t slaves.

It turns out that that there were black people in Tudor England, and there has been research on the subject, including Miranda Kaufmans great “Black Tudors”

But this didn’t really answer the question.   If black people weren’t slaves in Tudor and Stuart England when did they become slaves?  

We can trace some points on the trail along the way.   The first European slave markets were opened in Lagos in Portugal in 1444, before Columbus or Vasco de Gama.    The first black Africa slaves arrived in Latin America with the Conquistadors in the first decades of the C16th.   Britain had some unsuccessful attempts at establishing colonies in North America, but at the time King James I/VI comes to the throne and Shakespeare premiers Othello a century later Britain doesn’t have a new world Empire to send slaves too. 

James I/VI is a lot more enthusiastic about colonies, and Britain soon gains lands in the Caribbean.  The first slaves to enter British territory are probably bought from Spanish or Portugese slave owners in the first few decades of the C17th and sent to British plantations in the Caribbean.   

The first slaves arrived in Britain’s North American colonies in 1638 with the arrival of Caribbean slaves to Boston, then the Massachusetts Bay Colony. 

At that point each colony, as it wrote it’s constitution, was allowed to decide for itself if it want to make slavery legal, and in 1641 the Bay Colony voted to abolish slavery, the first British colony to do so.

For the next few decades the importation of slaves into the North American colonies was slow, until the establishment of Carolina in the 1670s, and the creation of the Royal African Company to increase the supply of slaves.  Even so the largest importers of slaves were still the Spanish and Portuguese colonies in Latin America, and the British plantations in the Caribbean. 

In 1712 slaves in New York City revolted, the first of a large number of revolts against slavery that spread across British North America, which lasted through the C18th.

At this point James Somerset enters the story.  Somerset was a slave, purchased by Charles Stewart in the North American colonies.   In 1679 Stewart travelled to England, bringing James Somerset with him.   Somerset lived in the United Kingdom until 1771 when he tried to escape.   As punishment for his attempted escape he was to be sent to the Caribbean, however with the help of some abolitionists he was able to move a writ of habeas corpus.   

The case was heard by Lord Justice Mansfield at the court of Kings Bench February to May 1772 at the end of which Somerset was set free.  The judge found that slavery had never been approved by statute in England and Wales, nor was it supported in common law.

The Somerset judgement effectively made slavery unlawful in the United Kingdom.   The number of slaves in the UK at the time was tiny, but the judgement had a profound effect on the transatlantic slave trade, making it illegal at least for ships travelling through British ports. From that point on the only debate would be how slavery would be abolished and whether compensation would be paid.

The Somerset judgement had a profound effect on the direction of American politics.  Previously the southern colonies of British North America had been loyal to the Crown, and discontent was concentrated in northern cities like Boston.   From the Somerset judgement onwards slave owners in the southern British colonies turned against British rule. 

A similar case was heard in Scotland  – Knight vs Wedderburn – confirmed that the Somerset judgement applied north of the border too.

After the revolution of 1775 and the War of Independence Britain lost many, but not the majority of it’s slave plantations. It also lost it’s main airports, according to Donald Trump, but that might not be historically accurate

A further huge blow to slavery was dealt in 1791 when Toussaint L’Ouverture led the first successful slave revolt, liberating Haiti from French rule and freeing the slaves.

The loss of Haiti broke France as a slave power, and removed one of the most powerful arguments in favour of slavery in the UK – if we gave up slavery the French would take over the trade and gain a strategic advantage.

In 1793 20,000 British troops landed in Haiti to seize the island.   Having defeated the French L’Ouverture inflicted an equal defeat on the British, inflicting huge casualties.   The defeat of both French and British troops by an army of former slaves brought home the realisation that an economy in which a small number of white Brits held large numbers of black Africans as slaves was precarious militarily so far from the British isles.

The formation of the Anti-Slavery movement, while important was largely after the fact.   By the time the 1807 Act was passed slavery was dead in the British Empire (although a form of bonded labour continued in British India).  

The major Caribbean plantation owners had long since sold up and bought land in the newly independent USA long before their business became illegal.

This doesn’t discredit the work of Wilberforce and his campaign completely, nor does it make the political campaigns of white middle class liberals a waste of time.   It is however worth noting that Turner’s great abolitionist painting “Slavers Throwing overboard the Dead and Dying—Typhoon coming on” was only painted in 1840, after slavery was made illegal, and nearly 50 years after the events it depicts.   Still a great work of art though.  

Current British politics contains 2 false narratives about Empire. The Brexity right’s world view is a jumble of Imperial nostalgia, trade deals with the Commonwealth and the 2 world wars. The middle class left world view is one in which plucky white middle class lefties ended slavery, or brought down apartheid.

Britain desperately needs a history of Empire that is based less around the domestic concerns of white people, but one which tells history through the eyes of James Somerset or Toussaint L’Ouverture.   Without that historical perspective we will be trapped forever between conflicting visions of the past, unable to understand the present.

At school everyone knew someone who told lies. Massive lies. If your dad had a new car their dad had a helicopter. If your dad had new job their dad was James Bond

If you went to Tenerife, they had been to Elevenerife.

If you went to Belmont you didn’t last long with that kind of fibbery, and most people soon grew out of it. Or have it beaten out of them.

But sometimes people grow up in a privileged world where they never have to accept the hard consequences of persistent bullshitting. Boris Johnson. Donald Trump. Trump has elevated this kind of bullshitting into an art form. Possibly the first authentic new art form of the C21st. Trumpshit.

Now that the dust has settled on Trump’s visit to the UK I thought it might be fun to go back and look at his claims that the NHS would be on the table in any future trade deals. Pretty much everyone I know got really angry about this, and plucky memes set sail across the internet powered by the retweets of politicians eager to pose as champions of state healthcare.

Trump increasingly looks like a rather sad figure, flying around the world on State visits to avoid facing up to his failure to achieve very much at home. He’s been on state visits to the UK and Japan back to back.

It’s not unusual for US Presidents to visit the UK, although these visits are mostly working visits to attend meetings of the G7, the G20 or NATO. State visits are rarer and most US Presidents only have 1 in the course of an 8 year term of Office. Some will remember George W Bush going to the pub in Sedgefield with Tony Blair. How Dubya didn’t spot we were taking the piss out of him I’ll never know. There were no state visits at all in the 1960s and 70s. Even Jimmy Carter’s trip to Durham for the Bi-Centenary was tagged onto a working visit.

Trump has been here twice in the last 12 months which looks rather like someone with time on their hands.

While we were members of the EU we were bound by EU procurement rules. EU procurement rules are a massive pain, and have lots of bureaucracy attached to it, but they does allow Governments to protect services like the NHS from commercial competition. The current rules that allow competition by private companies is a result of Government Policy, not EU regulation. As long as we are in the Single Market these rules apply.

But the model of Brexit currently being pushed by most Tory leadrship contenders has us leaving the Single Market in order to do global trade deals.

This means that we will be operating under World Trade Organisation rules not EU. This is where there is some truth in Trumps tweet. The WTO has it’s own rules on opening Government contracts to private sector competition which are much harsher than the EU ones.

If we go WTO we open up the NHS to competition by private sector companies from around the world under the Plurilateral agreement. If we decide not to do this then our companies are excluded from state funded contracts globally. Which makes our global trade deals worth an awful lot less. That’s the nature of free trade deals outside of trading blocs like the EU.

While everyone was getting angry with Trump about the NHS another big healthcare story passed most people by, and didn’t generate any memes on social media.

Circle Healthcare has lost the Nottingham Independent Sector Treatment Centre (ISTC) contract.

https://www.theguardian.com/society/2019/jun/09/private-health-firm-loses-nhs-treatment-centre-contract

I realise that this might not immediately leap out as something of massive importance but it brings to an end an era of NHS outsourcing dating back to the start of the century.

I’ve talked a bit about ISTCs before here, as part of a history of NHS Privatisation

https://wordpress.com/block-editor/post/jon-chadwick.com/1031

The original ISTCs were introduced by the Blair Government who had inherited big waiting lists and long waiting times from the outgoing Conservative Government. They had big plans to build new hospitals and expand capacity, but needed a quick short term fix to treat the backlog of patients.

The ISTCs were supposed to encourage private healthcare companies, often from abroad, to come to the UK to areas with long waiting lists to provide additional capacity.  This was the first big attempt by the NHS to bring in big healthcare companies from the US and around the world to deliver patient services.

Wave 1 was 25 fixed sites, and 2 mobile units, and wave 2 was another 24.   It was soon apparent that there wasn’t anything like enough interest from the private sector globally to make this work, and the programme was opened up to NHS organisations to run and operate them.  By 2006 nearly all ISTCs were run by the NHS due to lack of private sector interest. 

The last remaining big private sector ISTC contract was the Nottingham one, which was held by Circle Healthcare. They had run the contract for 11 years, and was their last remaining big healthcare deal.

Circle had made the headlines a few years ago when they took over running Hinchinbrooke Hospital – the first private company to run an entire NHS Hospital – only to hand the contract back 3 years later because they couldn’t provide NHS standard healthcare and make a profit.

The events with Circle and the ISTC follows a predictable pattern for private healthcare companies:

1. lobby Department of Health promising that they can deliver loads of great stuff for NHS patients if they get the right contract
2. fail to provide anything like the capacity they promise
3. do good work with routine elective work, but flounder with anything more volatile
4. get angry with lawyers if they don’t get their own way

The decision to bring it in house is consistent with the stealth nationalisation of the NHS which is going on. While Labour angrily campaign against stealth privatisation the whole edifice of the internal market is being eroded.

This might of course change with a new PM and a crash out No Deal Brexit. But it won’t change the reality of UK healthcare – private sector companies don’t have the capacity or the appetite for whole scale private deliver of NHS services.

I am still pretty supportive of the concept of private healthcare companies providing services to the NHS, as long as they use their own capital and take their own risks. I don’t mind Government Departments outsourcing routine admin tasks either.

But private sector companies across the board have over promised, taken on contracts that were too risky and too ambitious and failed to deliver. In doing so they have damaged their own industries, with the enthusiastic help of daft politicians like Lansley and Grayling.

The Institute of Fiscal Studies has commissioned Sir Angus Deaton to lead a review of growing inequality in the UK https://www.ifs.org.uk/inequality/

The press have got very excited about this, and rightly so – what could be more exciting than a 2 year study mixing economics with epidemiology?

Just think of the graphs!

https://news.sky.com/story/suicide-drug-abuse-and-alcoholism-linked-to-more-middle-aged-deaths-than-heart-disease-11719426

https://www.theguardian.com/inequality/2019/may/14/britain-risks-heading-to-us-levels-of-inequality-warns-top-economist?CMP=Share_iOSApp_Other

For those who don’t remember Sir Angus Deaton he isn’t the former presenter of HIGNFY, but the Nobel Prize winning economist who often works with his wife Prof Ann Case. Their work spans the fields of Economics and Epimedieology.

I’ve written about his work on life expectancy in the USA before:

https://wordpress.com/block-editor/post/jon-chadwick.com/468

https://wordpress.com/block-editor/post/jon-chadwick.com/513

The scope of the IFS Review is very broad:

“To give a sense of the breadth and ambition of the project, the themes to be covered here will include: which inequalities matter and why they matter; people’s attitudes towards inequality; their experiences of inequality; the political economy of inequality; the history of inequality; trends in economic inequalities; intergenerational inequalities; health inequalities; geographical inequalities; gender; race and ethnicity; immigration; early child development; education systems; families; social mobility; trade and globalisation; productivity, growth and innovation; labour markets; tax policy; and welfare policy” https://www.ifs.org.uk/inequality/about-the-review/our-approach/

This seems like a good moment to revisit 2 ideas that the review will look at – the geography of inequality and differences in life expectancy.

There is a new iteration of the Regional GDP/GVA dataset which shows how wealth is changing across different parts of the UK

These are the latest numbers for 2017 and growth is slow across most of the UK, with the exception of London. Even the South East show less than 2% growth.

This is just follows a longer term trend since the credit crunch:

London and the South East were growing faster than the rest of the UK before the credit crunch, and London has definitely grown faster since, but it is the dreadful rates of growth in places like the North East and Yorkshire and Humber that stand out. In these places the economy is stagnating significantly.

We can look at some other factors – growth since the EU referendum:

This is just a straight forward comparison of the 2 years before the referendum with the 2 years afterwards. London is actually growing faster than it was thanks to all of that QE. The economic slow down since the referendum is hitting the places that were hit hardest after the credit crunch and making regional differences worse.

GVA as a concept is similar to GDP, however it excludes the redistributive effects of tax and benefits. It show the impact of production and wealth creation, which is very similar to GDP but not exactly the same. These are chained value series which adjust for inflation.

To get an idea of how much these 2 numbers differ we can compare these 2 graphs from the IFS report:

This is a graph showing the top 1% of richest people in the UK’s share of national income:

It looks like the rich are getting richer regardless of how the economy grows. This picture, however, changes hugely when you factor in the impact of tax and benefits on incomes:

This shows an incredibly egalitarian picture (although I think the IFS have excluded the outliers of rich and poor to create this graph). Government policies such as Tax Credits have had a very significant redistributive impact.

Truly this is a triumph for socialism.

This starts to explain why the Cameron government found it so hard to cut spending. As they reduced overall Government spending the economy slowed down, particularly in places like the North East. As the economy slowed spending on benefits went up, wiping out most if not all of the cuts in Government spending. Cameron and Osborne tried to cut benefits payments, but only really succeeded in increasing poverty while still missing their fiscal targets.

https://wordpress.com/block-editor/post/jon-chadwick.com/972

We can start and look at the areas in the UK with the lowest GVA/GDP per capita:

And the highest

The slowest growing:

And the fastest growing:

The big differences leap out between urban and rural, fast growing and slow growing, old industry and new industry.

We can compare this data with life expectancy. In this case I have used life expectancy aged 65. These are the places with the shortest life expectancy for woman:

A much more familiar list of mostly urban areas

And the same data for men:

You might have spotted the far right hand column which shows the change between 14-16 and 15-17. Some parts of the UK are starting to experience a fall in life expectancy:

Sorry the table formatting is a bit wonky, there were so many places I wanted to highlight with falling female life expectancy that it was hard to cram them all in

This is the same data for men:

We might as well see the areas with the fastest growing life expectancy:

And men:

What this shows us is that the intersection of wealth and life expectancy is complex. It is easy to spot areas with low GVA which are low because of a lot of retired people. It is also easier to spot areas which have a fast increasing male life expectancy because they are former industrial areas which start from a very poor baseline.

But the list of areas with significantly declining life expectancy includes some very affluent areas like St Albans, which would suggest that this isn’t just about poverty, but about life style too.

A cycnic would ask the obvious question? Do we really care about inequality?

I would rather live in a society where no-one is poor and no-one is hungry but someone has a gold hat, and a society where no-one has a gold hat, but some people are poor and hungry.

I was brought up with the view that socialist politics that are rooted in working class communities concern themselves with tackling poverty, while socialist politics rooted in middle class neurosis concerns itself with tackling inequality

But in this case we can look to the USA and see that the combination of economic decline and declining life expectancy in non-college graduate, non-hispanic white populations has reached shocking levels.

We can see in the data above that we are starting to develop the same patterns of inequality of income and life expectancy that the USA is, although in the UK the picture is more complex.

Maybe we should get ready for the rise of a UK Trump articulating the grievances of non-college graduate white UK voters?

Sources:

https://www.ons.gov.uk/economy/grossvalueaddedgva/bulletins/regionalgrossvalueaddedbalanceduk/1998to2017

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/healthstatelifeexpectanciesuk/2015to2017

https://www.bma.org.uk/-/media/files/pdfs/about%20the%20bma/how%20we%20work/divisions/pre%20arm%20briefings/2%20pre%20arm%20briefing%20-%20life%20expectancy.pdf?la=en

Croydon Health Services NHS is about to advertise for a new Chief Executive.

This isn’t unusual. It’s been a troubled Trust on and off for a while, formed from the merger of Mayday Healthcare NHS Trust with Croydon Community Health Services. It operates University Hospital Croydon along with lots of Community Services, and a Community Hospital.

The Trust has the second worst accident and emergency performance in London, it sees just 60 per cent of type-one patients within four hours, compared to the 95 per cent target. Both the Trust and the Clinical Commissioning Group have been in special measures over the last few years due to endemic financial problems.

What is unusual is that it is a joint appointment with the Clinical Commissioning Group. Which means that the CEO will have responsibility for the purchaser and provider bit of local health services. The 2 organisations already share a Chief Nurse and a Chief Pharmacist.

This is a quietly radical proposal which undermines the fundamental principles of the NHS internal market – the purchaser/provider split.

It also pretty clearly illustrates one of the attractions of getting rid of the internal market – you need a lot fewer senior managers.

I can’t help but note that if you took University Hospital Croydon out of the equation the rest of the role is:

Commissioner CEO + Community Hospitals + Community Services + Minor Injuries + Intermediate Care = my old job.

How much of this is Matt Hancock (Secretary of State for Health and Parkour Champion), and how much is Simon Stephens (NHS England CEO) is unsure – my guess is it Stephen not Matt.

Next time someone tells you that the NHS is being privatised by stealth, feel free to tell them they are wrong. There is a quiet and stealthy dismantling of the mechanisms of the internal market taking place, unpicking one of the final parts of Thatcher’s legacy. This is a dry run for the full scale repeal of the Health and Social Care Act 2012.

And this is the Secretary of State for Health demonstrating Parkour: