In How Did Britain Come to This?, Gwyn Bevan critiques a century of systemic governance failures in Britain in areas from healthcare and housing to privatisation and outsourcing. Bevan’s sharp and compelling analysis reveals how ideological shifts have weakened the country’s public services over decades, writes James Barfleur, though the book stops short of setting out potential paths forward for politicians and policymakers.
One need not be a frequent user of Britain’s public services to know that our state infrastructure is crumbling. A passing glance at the shelves of a local bookshop (if any still exist) reveals no shortage of literature documenting the wilting state of Britain in 2024. Taking a simple journey by rail or attempting to see a GP provide added confirmation. And so Labour ministers arriving fresh into their departments face a very daunting set of challenges. To help them, and then help members of the public judge their actions, readers can take their pick from a plethora of recently released titles: Torsten Bell’s Great Britain?, Will Hutton’s This Time No Mistakes, Caroline Lucas’ Another England or Tom Baldwin and Marc Stears’ England. For those inclined to take a dim view of recent decades, there is Danny Dorling’s Shattered Nation or Sam Freedman’s Failed State. On the face of it, Gwyn Bevan’s new book, How Did Britain Come to This? A century of systemic failures of governance, might seem another contribution to this burgeoning genre. However, unlike those works, it does not offer a broad-brush analysis, instead focusing more narrowly on Britain’s systems of governance and the results that different approaches to governance produce.
To illustrate the potentially fatal consequences of poor organisational governance structures, Bevan opens with two scandals. The first, at the Bristol Royal Infirmary in the 1980s and 1990s, where the quality of paediatric cardiac surgery resulted in a substantial and statistically significant number of excess deaths amongst children under the age of one undergoing surgery; the second, at the Mid-Staffordshire NHS Foundation Trust in the 2000s, where abysmal levels of care were widespread in Stafford’s main hospital, resulting in excess deaths of patients. In his view, these case studies demonstrate just how difficult it is for governments to ensure that public services perform at a consistently high level.
Bevan contends that the overarching ideological context within which public services operate significantly impacts their performance.
Bevan contends that the overarching ideological context within which public services operate significantly impacts their performance. He examines the political settlements (or “rules of the game”) that provided this context in the recent past: first the minimal state of the 1920s and 1930s, followed by Clement Attlee’s post-war Labour government; then the advent of neoliberalism ushered in by Margaret Thatcher’s general election victory of 1979; and, finally, the post-Thatcher “financialised” state in which we currently find ourselves.
Bevan pins his colours clearly to the mast: we are now in need of a new political settlement ‘to tackle our five giant evils from 40 years of neoliberalism’.
Taking inspiration from William Beveridge’s famous 1942 report which described the five “giant evils” of want, idleness, disease, ignorance and squalor, and which laid the foundations for so much post-war social policy, Bevan pins his colours clearly to the mast: we are now in need of a new political settlement “to tackle our five giant evils from 40 years of neoliberalism”. He takes the issue of housing as an example, where Thatcher’s neoliberal policy settlement “has contributed to insufficient numbers of houses being built in a global market… that makes homeownership unaffordable to many”. The effects are felt not only by those forced to give up the aspiration of homeownership, those pushed out of their hometowns to seek decent employment, and by those prevented from moving out of the parental home, but by every British taxpayer. We all pay: the housing benefit bill doubled between the early 2000s and 2019, by the end of which it cost £22 billion. For perspective, in the same year, this was just under half of defence spending, and was roughly £5 billion more than was spent on overseas aid.
Despite these deleterious effects, “financialisation policies have shown the cockroach’s capacity to survive the havoc they have caused”, and Bevan argues, rightly, that “we are still living in the Thatcher settlement based on neoliberalism as if there were no alternative”. It is in response to this that he calls for a new political settlement, the “enabling state”, which according to his reckoning would make the performance of public services more transparent and accountable, as well as enabling them to learn more effectively from each other.
if [the book] is at its strongest presenting the need for change, it is at its weakest setting out an alternative.
Unfortunately, this vision of the “enabling state” is restricted to the book’s final few pages. Indeed, if it is at its strongest presenting the need for change, it is at its weakest setting out an alternative. Whilst Bevan fully acknowledges that his desire is principally to diagnose our problems rather than solve them, leaving “others more expert” to “debate how we ought to tackle them”, this feels slightly disappointing. His final sentence argues that “radical changes in the skills, staffing and attitudes of those working in Whitehall and Westminster” are required, but does not spell out what those might be. At times, too, the central argument risks getting lost amidst the technical detail. For example, a chapter on regional inequality, which compares the recent histories of Oldham and Oxford, and one on the UK’s response to the Covid-19 pandemic, in which Dominic Cummings emerges as an unlikely hero, are both brilliant in their own right. However, they are somewhat disconnected from the wider whole. And, despite the book’s title, Bevan makes no explicit mention of systems thinking. This is surprising given that systems thinking tools can help avoid the sort of organisational failures that led to the scandals at the Mid-Staffordshire NHS Foundation Trust and Bristol Royal Infirmary, as well as lead to better designed public policy.
Nevertheless, it all paints a damning portrait of a country which has “lost its way”. In concluding, Bevan revisits the Beveridge Report, refashioning each of its five major evils for 2024. Want, Bevan observes, has “re-emerged as a giant everywhere”; idleness has given way to insecurity, disease to ill-health, ignorance to miseducation, and squalor to despair. Few, I think, would argue with that. Our new government have their work cut out for them.
Note: This review gives the views of the author and not the position of the LSE Review of Books blog, nor of the London School of Economics and Political Science.
Image credit: John Gomez on Shutterstock.
