Wednesday 6 February 2019

Why bureaucrats don't stick to their own rules; and other significant modern phenomena

I once had a very interesting conversation with a man who was briefly influential for having invented what he (and others) regarded as an objective and quantifiable measure of the quality of life. The idea was that this could then be used to calculate how best to deploy health care resources to get the greatest amount of health per unit resource.

Sounds great! (Or, at least it does to a health service bureaucrat.)

The actual method entailed doing surveys (on, inevitably, non-representative groups) to ask individuals numerically to rate and compare various alternative scenarios of health. These opinions were then subject to mathematical procedures - of averaging, standardising and the like - to come up with what was supposedly an objective unit.

(A further, normal, assumption here is that people are inter-changeable units; so that what applies on average also applies to all individuals. The average quality of life with a disease - whatever that may mean - is applied to each individual with the same disease, when it comes to policy. That such an assumption lacks any scientific/ statistical validity seems to make zero difference.) 

The chap was educated and - in a way - intelligent - I recall him quoting Aristotle. But he simply could not understand that this procedure was arbitrary and anything-but objective: that it did Not At All measure the quality of life.

Modern bureaucracy is full of this Emperor's Nose* kind of thing (the definition of 'quality' is itself another very influential and long-lasting example); indeed such abritrary-mandatory-definitions must come from the very top of the bureaucracies, or else they would simply be laughed out of court as being obvious nonsense. Nobody knows how to do something, so an elaborate and expensive process is devised - which is officially declared to have solved the problem.

Exactly the same thing happened with Evidence Based Medicine - a particular type of research method (the very-large, randomised controlled trial) was declared to be The Best, most authoritative, only truly valid source of evidence concerning therapeutic effectiveness.

The assumption is established that procedure leads to truth. Q: Why do bureaucrats do this? A: Because bureaucrats control procedure - therefore truth.

But what is very interesting is that bureaucrats seldom stick to their own rules.

I worked for a couple of years in the National Health Service bureaucracy (as a part-time public health physician trainee); and the normal thing was to expend massive time and energy on establishing 'objective' procedures and rules that dictate proper decisions by agreed criteria; and then ignoring them half the time, and doing things for entirely different reasons.

Some of this is simply corruption: short-termist selfishness of individuals. Some of it is ideological - because Leftist imperatives always trump the proper-procedures, and bureaucrats affirm-to-themselves, and advertise-to-others, their own morality whenever they do this.

For example, a high-up explained to me how he was first to sack ('let go') more than a hundred staff in compliance to central government directives to 'cut red tape' etc; and that this tough cull was advertised in press statements. But that in reality essentially all of the 'sacked' staff were merely being re-deployed within the organisation, or sacked and rehired for the same function a few days later (and other similar scams) - this sticking to the letter and violating the spirit was a source of managerial pride; intended as educational evidence of competence.

Another analogous instance was that I was assigned to see what types of treatment could (and by implication should) be eliminated from state-provision because they were not really about health. What was envisaged was probably cutting provision of Alternative therapies. One major possible saving that I noticed was fertility treatment; on the basis that being infertile was a misfortune but not a health problem.

This was instantly and decisievly removed from the table of possible cuts to be considered; on the basis that one of the chiefs said that it was exactly the kind of thing the NHS ought to do, and indeed should do much more of - because (when effective) it made people so happy. Which was true; but making people happy is an entirely different matter than the official 'mission' of providing health care to (for example) reduce suffering, restore functionality and save lives.

I was trying to be a 'good bureaucrat' by applying the rules; but here was a harsh lesson in the truth of how things really work. Fertility treatment was a 'pet project' of a senior bureaucrat (for whatever reasons, good or bad) - and 'therefore' the rules did not apply, and indeed the rules were reversed.

My point is that people often complain about the materialism 'mindless' bureaucracy; that modern society runs like a machine ignoring the individual. But that is only half the truth of it.

We are indeed bound ever more extensively and deeply by the Iron cage of bureaucracy; with rules and procedures extending to more and more of life.

And at the same time; these rules and procedures are applied according to not procedural criteria; and the rules and procedures are frequently changed - in response to non-rule-based, non-procedural imperatives.

A vital factor in this is catch-all rules such as Terms of Service, or catch-all laws such as Hate Crimes. These make everybody in breach of regulations all of the time; hence every application is arbitrary - or more exactly, dictated by the whims and preferences of managers.

This duality is captured by the two dominant aspects of modernity: bureaucracy and the mass media. Bureaucracy represents arbitrary procedure; the Media represent arbitrary morality. Both procedures and morality are subject to frequent change - and different procedures and morals may potentially be applied to the same situation.

From the low level (you and me) this is experienced as arbitrary - on one side, a life encaged by strict rules, but arbitrarily applied; on the other a crazy life of evoked mob passions of excitement, lust, disgust and hate arbitrarily aimed-at unpredictable targets - with unpredictable outcomes.

Many modern people, especially women, crave a world of safety and predictability - which bureaucracy seems to offer; yet in practice it does not - in fact the world is much less safe and predictable with every year.

When understanding modern society and where it is going, we need to be careful not to be one-sided. For example, the European Union is often interpreted in terms of being a (Germanically thorough, French administrative elite ruled) bureaucratic paradise: a dull but safe technocratic project; by which all of Europe will be bound-together and unified by the imposition of thousands of helpful laws and rules...

An economic powerhouse - of 'free trade', planning, efficient allocation of labour and resources... of the unconstrained mobility of people and goods... A place where Human Rights are guarateed to all. A place where Hatred is illegal. A place where everybody is repected, and where such respect is enforced. A place where nobody - or no reasonabl person - will ever be offended by any-thing they abhor.

Or, alternatively and as-well, the EU is - mass media style - interpreted as the creation of a 'free space' within which culture can interact without constraint - a smorgasbord of cuisine, languages, architecture, landscapes - holidays and travel and cosmopolitanism...

Yet the primary, inflexible, strategy of the European Union is not captured by either of these. The one thing upon which the actually-existing EU insists above all else is mass immigration from outside the EU - from Africa, South Asia and the Middle East...

Mass immigration to the UK brings out the stark contradiction at the heart of modernity. We have a bureaucratic society in which more and more is monitored and controlled; into which comes unknown, unmeasured, uncounted but very large numbers of people to whom the rules are not applied.

The mass media do not notice this. From 2000-2010 through England towns were visibly and rapidly transformed, schools transformed, health service usage transformed; but the local news media did not notice while this was happening - when I looked at the records of my local newspaper there was nothing at all, ever.

So we do not live in an efficient bureaucracy, nor do we live in a world where a crazy out-of-control media can do what it wants. Rather, there is a long-term strategy above and beyond these and all other human organisations.

Everything important happens, or has already happened, at the level of the basic assumptions that lead to bureaucratic rules, that lead to media stories and ignorings.  But these basic assumptions are concealed and protected by every means possible, including by contradictory means.

There is, in our society - as it is organised - never a time, and no place or situation, in which it is regarded as appropriate to identify and discuss the basis assumptions upon which everything is based.

These basic assumptions that dictate everything, which justify everything; just 'appear' and get imposed. These basic assumptions are denied because they are arbitrary - and they are arbitrary in a way that is obviously false. 

That is how our society is controlled. Because the means of control - i.e. the basic assumptions that lead to all the specifics of control - are kept invisible; and because imperceptible their existence is therefore deniable, and is in fact denied.

What we see, down-here, is something like the health service rejecting some treatment because it objectively does not benefit quality of life, or that there is no objective 'evidence' (ie mega randomised trails of the right sort) to support it; and this is implemented by chains of committees endorsed by the votes of experts panels and 'independent' regulatory agencies... And perhaps the mass media run scare campaigns, based upon the 'evidence' that they report that somebody says that the treatment did their child some kind of horrible harm; and this is endorsed by a charity or pressure group (nature and funding not known, nor cared about) that advocates in favour of something that sounds nice...

And so a drug is banned - or a new drug is implemented... or anything else.

There is a juggernaut of expert evidence, a juggernaut of hysterical public opinion. There is a facade of procedure - but nothing important is ever decided by procedure ...

Bureaucracy is just for the little people.

*From 'Surely You're Joking Mr Feynman': This question of trying to figure out whether a book is good or bad by looking at it carefully or by taking the reports of a lot of people who looked at it carelessly is like this famous old problem: Nobody was permitted to see the Emperor of China, and the question was, What is the length of the Emperor of China’s nose? To find out, you go all over the country asking people what they think the length of the Emperor of China’s nose is, and you average it. And that would be very “accurate” because you averaged so many people. But it’s no way to find anything out; when you have a very wide range of people who contribute without looking carefully at it, you don’t improve your knowledge of the situation by averaging.

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