Posts tagged ‘government’

May, 2014

Long-term care for older people

Professor Jon Glasby

Image from istock: Give Me Your Hand

Image from istock: Give Me Your Hand

As part of the ‘saving humans’ theme, a number of contributions from across the University are likely to focus on the causes and implications of climate change – potentially one of the most significant current and future threats we face. At first glance, all this feels a long way away from the day-to-day reality of front-line health and social care (which is our area of specialism here at the Health Services Management Centre). And yet, there’s an unusual but uncanny similarity between debates on climate change and current controversies around the future funding of long-term care for older people…

This probably sounds odd initially – but different Ministers and governments over time have started to look for solutions to the funding debate and shied away when things got too difficult. Although it’s often neglected as a policy issue, the quality and funding of services for older people is a major social issue that touches us all in different ways and at different times of our life. Yet devising a solution to such a complex, embedded series of problems will inevitably be long-term, controversial and unpopular. Crucially, the benefits won’t be felt for many years – so a current political leader will have to take significant pain and criticism for unpopular measures that don’t pay dividends until much later (when someone else gets the credit). Faced with a potential backlash to any of the solutions that might actually work and with an election looming, it’s tempting to kick the issue into the long grass and leave it to the next person to sort out.

For me, this is precisely like the climate change debate. Deep down, many of us as private individuals know there’s something serious at stake here and that something fundamental will need to change. But it’s so long-term and so difficult that it’s easier just to put it off to tomorrow and assume that someone else will sort it out…

In long-term care, we’ve seen this time and time again – from New Labour’s failure to implement the central recommendations of the Royal Commission on Long-term Care, the lack of a response to Sir Derek Wanless’s review, the failure to implement plans for a ‘national care service’ and what many now feel is a watering down of the proposals of the most recent Dilnot Review. And yet the issues at stake are serious and far-reaching. We have a health and social care system designed with 1940s society and demography in mind which has felt increasingly unfit for purpose over a number of years, and is now ready to burst at the seams. Putting this off until another day simply isn’t a credible response – but it wouldn’t surprise me if – like climate change – this is exactly what we do (again)…

Jon Glasby is Director of the Health Services Management Centre (HSMC) and Professor of Health and Social Care. 

In 2010, HSMC worked with Downing Street and the Department of Health to review the future funding and reform of adult social care. Our subsequent report was launched by the Prime Minister and was a key plank of the government’s subsequent White Paper – see:

Glasby, J., Ham, C., Littlechild, R. and McKay, S. (2010) The case for social care reform – the wider economic and social benefits (for the Department of Health/Downing Street). Birmingham, Health Services Management Centre/Institute of Applied Social Studies

Other useful links:

 

February, 2014

World Government: Not Quite an Idea Whose Time has Come, but No Longer So Far from the Academic Mainstream

Dr Luis Cabrera

I can say without much reservation that I am one of the most avid students of world government alive today. Of course, I’m careful when and where I say that…

Actually, even in my relatively brief academic career (12 years, if you count from the PhD award date), there has been, if not a sea change, certainly a surprisingly strong trend toward serious academics taking the world government ideal seriously again.

Consider this: when my lead PhD supervisor and I were trying to put together a doctoral supervisory committee in the mid-1990s, we approached a staff member at the same US institution who had a solid global reputation as an international relations theorist. He was known for his cutting edge theorization of relations between nation-states. Yet, when approached about helping to supervise a thesis exploring the contemporary case for world government, he came back with a very rapid ‘no.’ It just wasn’t a topic he saw as meriting serious scholarly consideration, he said.

Now, such a response would likely be much harder to give. The past two authors to win the International Studies Association’s prestigious ‘Book of the Decade’ award, Alexander Wendt (2000) and Daniel Deudney (2010), have made world government enquiry a clear part of their work. Wendt, who is enormously influential for his work on how ideas and ideology can shape nation-states’ behaviour, has argued for the ‘inevitability’ of a world state – in 200 years or so. Deudney argues that the continuing threat from nuclear weapons remains so great that world-government creation is a necessity, though a weakly empowered one narrowly focused on weapons control.

Wendt and Deudney are only two of a range of IR scholars, economists, international sociologists and moral theorists who have recently explored the feasibility and desirability of full global political integration. Many others have taken up international institution building on a smaller scale, but still one that would require states to cede significant powers upward.

This might, in fact, be thought of as a second ‘heyday’ in world government thought. The first can be dated roughly from 1945-50. It was spurred by the US nuclear destruction of Hiroshima and Nagasaki, Japan, in August 1945. What had been unimaginable in war was suddenly cold reality. This prompted many to think that political realities must be reconceived as well.

This wasn’t  just a fringe few, either. Leading academics – including Albert Einstein – authors, jurists, political figures and civil society leaders around the world called for, or at least expressed openness to, a world government capable of meeting the awful new threat.

The following quotation from Birmingham-area MP Henry Usborne gives a sense of the urgent rhetoric of the time. In his maiden speech to Parliament in 1946, Usborne outlined a plan for Britain to lead the way to a security and political union with like-minded democratic countries that could evolve into full world government:

‘I imagine that this proposal would meet with a great deal of opposition. That I do not mind. I am quite certain that if we doubled the opposition we should get 10 times the enthusiasm from the common people all over the world in support of a proposal such as that. Is the proposal fantastic? Is it Utopian? Yes, it is both fantastic and Utopian. It is just as fantastic as the atomic age in which we now live; it is just as Utopian as the hope of world peace.’

They ‘heyday’ period ended almost as quickly as it had begun, with the advent of the Cold War and fears of Soviet global domination.  Though some academics and others continued to make the case for world government, they remained mostly on the fringes for about the next 50 years.

Today’s resurgence of academic literature on world government, spurred in part by globalization, is distinguished by the range of disciplines involved and the prominence of some of those involved. Their arguments tend to fall into three camps. In the first, authors such as Deudney highlight continuing threats from world government, as well as terrorism and other security issues, as reason to pursue comprehensive forms of integration between nation-states.

The second camp is concerned with democratic rule. Here, ‘cosmopolitan democrats’ argue that, in an age of intensifying globalization and global economic integration, domestic democracies are losing their powers to live under laws of their own making. Thus, democratic decision making should be shifted upward, generally to include all of those who are affected by specific processes of globalization, or by the decisions of global bodies such as the World Trade Organization. Few of these authors would claim the world government title for their work, but several do advocate the creation of powerful, binding global institutions with broad powers to tax and spend for the common good.

A final camp is concerned with the promotion of justice and human rights globally. Here, authors argue that state sovereignty throws up predictable barriers to actually realizing justice or securing the rights of all persons, so forms of integration should be pursued between states. My own work would be situated here. I have argued in a couple of books and several articles that the current global system will routinely underfulfill individual rights: http://www.birmingham.ac.uk/staff/profiles/government-society/cabrera-luis.aspx That’s because it leaves states as the final judges in their own cases about obligations. Imagine if we were all left to judge which rules or laws we would prefer to follow, or especially how much tax we’d like to pay. We’d mean well, but chances are we would see other priorities repeatedly getting in the way of ‘donating’ the tax voluntarily that would be needed to maintain social institutions.

Like most students of world government, I take a very long term view. If it ever will be possible to create global institutions capable of routinely protecting the rights of all persons, I have suggested, we shouldn’t expect to see them develop for many hundreds of years. My recent work has been concerned with the kinds of integration and related changes that might be possible in the near term, and yet would conceivably contribute to the long-term aim. I have considered in particular some potentially rights-enhancing forms of regional integration.

I have enjoyed being able, as this week’s Saving Humans ‘guest blogger’ to share some thoughts on recent developments in democracy and human rights. To recap: on Monday, I discussed a new organization, Academics Stand Against poverty, that is dedicated to strengthening the academic voice and direct positive impact on poverty issues globally. On Tuesday, I discussed my own work on global citizenship and immigration, with emphasis on field research among unauthorized immigrants, and with anti-immigration and migrant-rights activists.

On Wednesday, I talked about current work on human rights and prospects for, or possible reasons to purse, trans-state democracy. I looked there at how India’s National Campaign for Dalit Human Rights had sought to reach out to the global human rights community to bring pressure on its own government to do more against caste-discrimination. Thursday’s entry drew connections between the theoretical concerns there and in the struggle by opposition leaders and activists in Turkey to maintain a free, open democracy, against the backdrop of possible accession to the European Union. Today’s entry took the much longer view on rights and integration.

Luis Cabrera is Reader in Political Theory, Department of Political Science and International Studies, University of Birmingham.

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