National food service

The issue of obesity has been rearing its ever fatter head again in the medical community this week. Firstly we had the worrying cohort study findings published by researchers from the Hebrew University-Hadassah in Israel and the University of Washington in the US. The Researchers found that higher maternal BMI before pregnancy was associated with increased BMI in children, as well as larger waistlines, raised blood pressure and increased blood levels of insulin and fat. Greater maternal weight gain during pregnancy was also associated with increased BMI, waist size and levels of fat in the blood.

Secondly, we have had experts from the University of Oxford’s Public Health department calling on the UK government to impose a “fat tax” of at least 20% on the costs of unhealthy food and soft drinks. This was based on research looking at theoretical models, which priced in the negative externalities to the cost of unhealthy foods, and suggested the most vulnerable groups in society are more likely to change their own behaviours if food prices more accurately reflected the negative impact on their own health.

For those of passionate about strengthening society, the role of the state in guiding people what to eat and drink is always seen as a bit of tricky area. Often the state can be seen as ‘nannying’ rather than trusting society to make their own choices – “nobody should tell me what to eat and drink: if I want to eat crap then that is my right regardless of how that affects my health or impacts on my wellbeing”. I think that principle is right – the state has no right in telling people how to live their lives. For sure it should be able to inform and signal choices that are in a citizen’s own long-term interests, but it should not dictate those choices …unless it undermines society as a whole.

And that is point about obesity – the costs of unhealthy eating and drinking are absorbed not by the individual but by society. Effectively society is subsiding the profits of fast food and soda producers such as McDonalds and Pepsi as their high fat and high sugar products do not price in the crippling costs of future healthcare to society which is caused by high fat and high sugar products (i.e. Diabetes, heart conditions, pregnancy complications, etc). So there is a market failure here with potentially catastrophic effects to the future viability of society’s health services. This means there is a legitimate argument for the state to intervene ensure a stronger, not weaker, society for current and future generations (regardless of how much you like that cheap daily big mac!)

How should the UK state intervene? Well, the UK has its own huge National Health Service (NHS) which spends billions of taxpayers money on treating health conditions, many of which could have been prevented through better diets and healthy lifestyles. Recently it was estimated that 40% of cancers treated in the UK are preventable with changes to lifestyle. So, why doesn’t the NHS in the UK spin-out some of it’s vast resource and budget to set up a National Food Service? An ‘NFS’ could oversee the current food market in the UK to ensure people can get the right food at the right prices? The NFS role would probably be a regulator and subsidiser of food provision in the UK (rather than provider as market provision is already established).

The NSF shouldn’t be a state body either. While the state could give it regulatory powers and guarantee an increasing percentage of the total NHS budget (relative to national obesity rates), the actual day-to-day work could be contracted out to an enterprise that sees fit to bid to run the service. A citizens jury of 100 people could be randomly selected from the NHS database to serve a two-year term to review the bids and appoint the service contract to the bidder it thinks will best represent the interests of society. That jury will also have powers to hold the service provider to account for the regulation it carries out and the subsidies it gives throughout its two-year term.

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Big lottery winners

Last week the organisation which awards money, generated from the massively popular UK National Lottery game, to good causes announced its priorities for the next three years. Given that BIG (the name of the grant-giving organisation) will have a cool £1.5bn to spend the potential to support good causes in Britain is immense. A lot of their priorities sound absolutely right – such as supporting good causes which focus on preventing expensive social problems in the first place. Yet, given the problems British society is struggling with at the moment (i.e. youth unemployment over a million) and the consequences communities absorb (i.e. the london riots) could there be the potential to do something game-changing with that substantial pot of money?

The way the money is spent is as important to society as what it is spent on and how much is spent. How does the money get from the hands of the lottery players to the good causes? Well at the moment 13% of every ticket cost is centrally collated and then distributed to a wide variety of good causes through the administrative organisation called BIG. State politicians traditionally have let BIG run their grant funding programs independent of government directions, which given the incentives for short-term popularist programs in the Westminster model is probably a good thing.

However, does the allocation of £1.5bn via appointed officials really engage society and strengthen the bonds and relationships within communities that we know are especially vital in times of economic hardship? Maybe, but I think there is a more effective way of allocating the money. Why not allocate the cash equally between the 150 top tier local administrations in the UK (equivalent of the 58 counties in California) for the next 3 years and then use it as a challenge fund for everybody aged under 25 to enhance their community? Rather than funds being allocated by officials, the local councillors together with local business partners could hold “dragon’s den” style sessions in the town halls to allocate the money.

JobCentrePlus and providers of the work programme together with local mentors from local businesses could encourage and support young people to develop pitches and implementation plans to put in front of the judging panel. Equally existing good cause organisations which currently rely of lottery grants may be forced to amend their business model so that they employ some more young people to make the pitch for them. Either way, there is real potential for the £1.5bn over the next 3 years to be focused on engaging and creates opportunities for young people to be active in the labour market through the spending system alone. Who knows maybe some young people will come forward with an awesome idea to ensure decent community support for the elderly living alone – a crisis that is now really biting across many local authorities in the UK as local service budgets become smaller.

Could state politicians make this happen? Yes, and it could be a popular move. However, the real question is is it likely to happen? The answer at the moment is no, due to path dependency. Many organisations are dependent of lottery grants – they do not want this funding stream disrupted when it is getting ever harder to raise money elsewhere. Equally one can’t imagine the grant-allocating officials themselves at BIG wanting to put themselves out of a job, regardless of whether the money could be allocated more effectively through a different mechanism – people have mortgages to pay first and foremost! Still, with a bit of imagination maybe the Executives at BIG could see an alternative business model where they act as on-call consultants with each council contracting an advisory service from them on the cost-effectiveness of local pitches and programs? Indeed, perhaps BIG should spin itself out as an employee-owned mutual and look to cash in on a potentially lucrative advisory service to lots of local administrations?!

 

Mind changers

Regular listeners of the BBC world service will know Claudia Hammond as the presenter of the weekly magazine show Health Check. However, she is also one of the most engaging psychologists around making potentially complex theories accessible to those of us who struggle with a Psychology 101 test! In London she has recently launched her new book ‘TimeWarped’ and in order to find out what it’s all about most people have already been enjoying the tests of their own time perceptions with the games on her website.

At the end of April Hammond presented a fascinating programme in her Mind Changers radio series focused on ‘Donald Broadbent and the Cocktail Party‘. Most people who know about this programme have already listened to the 30 minute broadcast. It looks at the groundbreaking research of Broadbent, the Director of the Medical Research Council’s Applied Psychology Unit from 1958 to 1974 who launched the cognitive revolution in psychology in Britain. With his innovative dichotic listening experiments, Broadbent gained a unique understanding of the ‘cocktail party effect’: significant information, such as our own name, intrudes on our consciousness, even when it’s embedded in auditory information we’re not apparently attending to.

There are some pretty neat dichotic listening experiments to play along with (make sure you listen through headphones!) on the show, and you soon learn that when different conversations are happening in different ears it’s actually quite hard to pick up the key messages. However, with a little bit of help from Hammond – notably to focus your attention on one ear rather than both – you can effectively tune in to key points and cancel out the background noise. Equally, subtle changes in the messenger itself has an impact such at the the pitch of the voice (essentially a women’s voice, as we know, is better than a man’s dulcet tones!)

Now, this got me thinking about public policy! In the UK and the US pre-teenage children are bombarded with loud and subtle commercial messages on a daily basis: drink sugary sodas to become as sporty as David Beckham, eat fatty fast food to be as cool as your dad, wear padded bras to be the next Britney Spears (seriously!), pester your dad to spend $100 on trainers that cost less than a $1 to make and will last less than 3 months, pester your mum to buy that cheerios cereal not just so you can have a sugar high on the bus while going to school but also a sugar low in time for the first maths lesson of the day. Brilliant! Of course, one parent’s obese, materialistic, hyper-active child with developing type II diabetes is also a shareholder’s dividend, a salesmanager’s bonus, a factory worker’s salary and a Government’s GDP growth figure.

Both the effective functioning of society and the state are currently dependent on mass consumerism, whether you like it or not. However, couldn’t the state help shape consumer demand towards products which are in the interests of society and citizens? Surely this would be a win-win as producers could also shift their production from sugary sodas to fruit smoothies and from crap breakfasts to nutritional ones in response to changes in consumption patterns. The problem is that – given current path dependencies of mass production and the mark-up that can be made from crap (i.e. refined sugars and hydrogenated fats) rather than the genuine deal (fruit and wholemeal products) – it is not in the interests of the producers to change their marketing practices – it’s much easier to socially engineer kids into thinking crap is good for them.

So, this brings us nicely back to the dichotic listening experiments Broadbent did. For those of us passionate about a stronger society, supported by the state, we need a way of getting children to focus on those messages which inform how they look after themselves, the people around them, and the communities they live in. Many children already get these messages from good parenting, but the state should help parents who have to struggle day-in-day-out against multi-million dollar commercial messages all aiming to socially engineer children to behave and consume in ways that are counter-productive to a stronger healthier society.

The state’s role remember is to support society. One of the ways it can do this, and help parents struggling to build resilience against ever-stronger commercial pressures, is to really think about the messaging kids receive in schools and how they receive it. In the UK schools are monopolised by teachers – their job is rightly to empower children with new knowledge and skills to learn. In the 21st century this is necessary but not sufficient to strengthen a liberal society.

In the same way commercial companies hire advertising consultants to sell a message, why can’t schools employ specialists in the dark arts of advertising to explain to kids how they are being socially engineered? In the same way David Beckham employs a nutritionist who would never dream of recommending high sugar drinks to further his sporting careers, why couldn’t schools employ specialist nutritionists to explain to kids the right sort of diet they need to achieve sporting greatness. While Britney Spears employs personal stylists, why couldn’t schools convince local hairdressers and make-up artists to share some their skills with the kids about how to enhance natural beauty (and self-esteem) themselves through creative thinking and having the courage to be original rather than paying for branded goods endorsed by a troubled singer whose body language on stage actually conveys a very sad, and ugly, inner-misery.

Perhaps the UK Treasury could encourage advertising agencies, nutritional experts and local beauticians to work with schools by either introducing a business rate discount or some conditional deregulation for those that approach and work with schools?! We know the opportunity for state institutions to strengthen society is huge, but increasingly challenging in a world of increasingly loud commercial messaging. However, by ensuring kids have the tools to focus on those messages which strengthen society the state can really support all those parents and teachers who are trying so very hard everyday, every hour to strengthen the next generation of society.

Psychology of proposition 29

At the recent science of doing good event at the stanford centre for social innovation Todd Rogers gave a fascinating talk on the psychology of voter turnout. Marguerite Rigoglioso gives a good overview on the CSI site which is well worth a read. Getting the vote out is not just an important issue for presidential candidates and political parties, it is fundamental to the state earning legitimacy (collective trust) from society. If people don’t participate in the electoral process – especially if there is a group effect – then those people and groups are effectively disempowered.

Rogers, in his talk, gave a whole range of useful and simple ideas for getting the vote out (from getting potential voters to commit to a plan to vote, to emphasising a positive norm around voting in a state) However, I was especially interested in a specific study from the 2010 election that Rogers cited looking at the importance of personal relevance and accountability. Rigoglioso notes this study in her post: researchers sent one group of potential voters a psychologically sophisticated mailing encouraging them to vote. Another group received the same mailing, plus in the top right corner a box saying: “We may call you after the election to talk about your voting experience.” Adding that box increased the effectiveness of the mailing in terms of the voting it stimulated by almost half.

That’s a pretty impressive impact! On June 5th voters in California will be asked to make cigarettes more expensive. As outlined in the Examiner today Proposition 29, would raise the state’s excise tax on a pack of cigarettes from 87 cents to $1.87, with the revenue to go toward research on cancer and other tobacco-related diseases. It would go into effect in October and is expected to raise about $735 million in the first year. That is a lot of money, yet I’m not convinced of the personal relevance is being maximised in the design of this proposition. There are more innovative designs of such a fund that could more actively engage and interest society in this proposition – designs which would give the state more legitimacy for this intervention.

Firstly, rather than the $735m going to cancer research by default (which is effectively a californian subsidy for federal & overseas cancer research programs), the fund could be used as a challenge fund for Californian citizens to do something to enhance social bonds and relationships in their own neighbourhoods. Individuals, families, blocs or whole neighbourhoods could collaboratively bid for some seed funding to set up some community activities. Surely this would be more salient to the everyday lives of California, especially those that are at less risk of lung cancer because they don’t smoke. However if Californians don’t bid for the bucks, and there is a large pot of money left over then that – by default – could go cancer research programs. So effectively Californians get first choice on spending, but if society doesn’t actively step up to the challenge by default the unused money could then go to the federal and overseas cancer research programs – a pretty good incentive for Californian communities to get active with their bids then!

Secondly on the campaign mail outs currently encouraging Californians to support proposition, there could be a box in the top right hand corner saying “We may call you after the election to talk about your voting experience and your priorities for spending the $735m fund to strengthen your community.” Based on Rogers research, this should both encourage more people to vote for the proposition as well as shift citizens perception from being a passive recipient of the newly generated fund to an active player in how the funds are spent to strengthen bonds and relationships in their community. Such a re-think of the design of proposition 29, together with a few tweaks to the wording of the campaign mail outs, has the potential to significantly strengthen Californian society. Let’s hope the State reads Rogers research soon!

Welfare posturing

‘Welfare dependency’ has been making the headlines on UK media websites over the past couple of weeks. The UK – like the rest of Europe – is falling back into recession and with no light at the end of tunnel (growth) the media, politicians and public’s attention is, it seems, increasingly focused on how the reducing pot of taxpayers money is distributed throughout the country. Calls for the state to spend less (on running itself) are reported on all sides as can be expected (the US economy is actually growing and the calls to slash state spending are equally as strong). The other favourite target is welfare benefits – payments which are far more generous in the UK than they are in the golden state.

The British welfare state has provided a ‘safety net’ for people who can’t work, and can’t generate their own income, for the past sixty plus years. Those who can work subsidise, via state benefit payments, those who can’t. More recently though those who do work have increasingly questioned the validity of those who say they can’t work. This is one of the reasons why the state is currently reassessing people who have been claiming long-term incapacity benefit to see if actually they could return to the labour market (if given some intensive support to get over the barriers created by being out of work for a long time). Job creation in the UK will have to pick up though if such an approach is to work.

Yesterday, curiosity led me to examine some of the 2010 baseline figures, published by the UK government,  that make up the 2.6m Brits who were claiming either Incapacity Benefit (IB) or Employment Support Allowance (EA). Three figures stood out to me. Firstly, from the data it seems that around 1.1 million were claiming for mental and behavioural episodes (within this nearly half a million are claiming for depression). That is not a positive reflection of UK society today, and the state’s past efforts to strengthen community resilience. Would that figure be so high if the state had invested in strengthening social bonds and community relationships that supported people to connect with themselves, their families and those around them? If not, then the UK has to look to the future and really think how it can enable people to trust and collaborate with each other on a much greater scale.

Secondly, it appears that nearly a third of those claimants have been on these benefits for more than 10 years – that is tragic; that is state institutionalised dependency, regardless of whether people are actually able to participate in the labour market or not. For people who would now be reassessed as being able to work the state should have been given a lump sum of money (equivalent to 3-years benefit payments) on condition that they accept intensive support and mentoring to start their own enterprise: it is surely better to assume people have a talent waiting to be unlocked than to assume people are happy doing nothing? For those that genuinely can’t work then a calculated lifetime benefit payment  lump sum should have been paid directly or invested on their behalf in a community-run mutual, from which they or their carers are responsible for drawing an income themselves. Enhancing the responsibilities of society on welfare could help shield welfare payments from being exposed to the dehumanising knockabout politics on ‘state handouts’, which no genuine welfare recipient should have to tolerate.

Thirdly, back pain seems also to be a key cause of long-term claims, with just shy of 170,000 people claiming IB for this reason, of which 42% had been claiming for more than 10 years (almost 40,000 of the 600,000 ESA claimants also cited back pain). After seeing how most Londoners hunch on the underground trains or slump into their chairs I’m not surprised at this high figure! However I am surprised that the state office for education hasn’t done anything about it. Surely it is in the interest of both the state (future saving to health and welfare budgets) and society (personal well-being) for people to learn good posture techniques when young? Whether it is the parents or the schools responsibility to ensure children have the capability to sit, stand and breathe correctly is a secondary question; the first order priority is to ensure every child has it.

What is more puzzling is that a relatively simple posture programme (the Alexander technique) has been around since the middle of the last century yet no one thought to mainstream this either in schools, or just society more generally? This learning could prevent future back pain by strengthening postural muscles, improving coordination and flexibility, and decompressing the spine. In the last decade the British Medical Journal (an established research publication for UK doctors) published a neat randomised control trial of alexander technique lessons showing a positive impact in reducing levels of back pain. If everybody learnt some good posture habits at an early stage, surely it would be a win-win situation for both state and society? Surely we all want to see our children walking tall, relaxed in themselves portraying a sense of confidence to the world around them?

Library crowdfunding

This month the California State Library, opposite the Capitol in Sacramento, is celebrating the 75th birthday of San Francisco’s fabled Golden Gate Bridge. On May 16, the monthly “A Night at the State Library” program will present the 1968 film Bullitt, starring Steve McQueen as a San Francisco police lieutenant and “showcasing an almost 11-minute car chase in which the Golden Gate Bridge is visible”. Brilliant!

These programs, which enhance access to and engagement with great public institutions such as libraries, are a positive contribution the state can make to help strengthen society. They not only promote greater knowledge and learning but, more importantly, also provide opportunities for people to come together, connect and exchange ideas with each other – the very fabric of a good society. This is why the work of the California State Library Foundation (CSLF) is so important – it provides private support (through membership, donations, grant-bids) to enhance the role of the state library as an active partner within society (i.e. Governors book fund, California research bureau work, Saturday hours program, etc)

For scholars of social innovation though, there is surely a huge opportunity here to work with the Foundation to expand entrepreneurial support for those using the library to develop their innovative ideas. Many potential entrepreneurs (regardless of whether they realise they are one yet) do spend time thinking, researching and meeting in Californian state libraries. Some of these may have some outstandingly good ideas, but most of which will never get off the ground for various reasons (i.e. not realising potential market, lack connections to angel investors in the Bay Area, lack critical mass support, etc)

How can the California State Library Foundation help? Well, it could provide an on-line platform for a Californian state library user with an idea to pitch it to the whole membership (all users) of state libraries. The platform would allow members, if they like the idea, to collaborate virtually and provide start-up capital for idea to become a social venture. For example 1000 members could all like a pitch they read about, and the first 500 to sign up $10 each to support the new social venture could each be given 0.1% equity share in the venture (it would be an open question what dividends they are investing for: could be financial or social impact returns).

Obviously such investment platforms are not new – we know them as ‘crowdfunding’ – but they are rapidly becoming more credible with new technological innovation. State institutions – such as libraries – which are in the fortunate position of already possessing access to both potential innovators as well as a critical mass of potential investors should look to exploit this institutional advantage to catalyse more connections, for the benefit of society. This is especially the case given the recent passing of the JOBS Act that now allows crowdfunders to receive equity in small companies

For entrepreneurs using the State library, an in-house crowdfunding platform has three extremely powerful advantages. Firstly, in an era when credit and institutional VC is more risk-averse, the platform provides a much needed alternative to raise seed capital and – given risk will be dispersed across a collaboration of micro-investors rather than concentrated in the hands of a couple of big ones – ideas with greater social returns (but bigger financial risks) are more likely to be funded. Secondly, it provides an instant feedback mechanism for aspiring entrepreneurs and their ideas: if people don’t think it will work they won’t invest – this is invaluable information for entrepreneurs as it signals a sharp return to the drawing board before any more resource is wasted pursuing an unsustainable idea. Finally, it connects the idea with a potential market: the mass of people who see it and invest in it may also provide the first wave of customers / participants for any new product / service.

The CSLF could also move beyond simply facilitating the crowdfunding platform to being an active player in it to. In the UK Adrian Hon, the founder of the online games company Six to Start, has written recently about potential hybrid crowd and public funding models. Essentially the CSLF could take an initial stake in ideas that it thinks would benefit the work of the California State Library and the Foundation’s mission. This would firstly provide an incentive to entrepreneurs to come forward with ideas that could have direct relevance to the library and the Foundation’s mission (as they are more likely to secure funding – individual funders will be more likely to sign up if they see an insitutional investor has taken an equity stake). Secondly it could encourage both the state library and its users to work in greater active partnership as they all have a mutual interest in ensuring their investment is successful.

I think this is something the CSLF should seriously consider – it could have huge benefits for itself, the libraries users, and most importantly Californian society.

Gaming the technocrats

Last week the special advisors network in Westminster (all of the UK governing politicians personal spin-doctors) were having a collective belly-laugh at the expense of the non-partisan permanent bureaucrats who are responsible for the everyday smooth running of UK major offices of state. The extent to how efficiently they run them and execute their political masters orders – not least the spending of large amounts of taxpayer bucks – is a question a powerful independent parliamentary committee called the Public Accounts Committee (PAC) is constantly trying to get to the bottom of. Unfortunately the head of the Ministry of Defence, Ursula Brennan, failed to provide any convincing answers last week triggering much deeper questions in the UK about the competency of permanent officials (something the political special advisers have been making jokes about since day one of the new UK coalition government: “…the engine of a lawn mower, and the breaks of a rolls royce”)

The entertainingly aggressive chair and deputy chair of the committee (Margaret Hodge and Richard Bacon) seem determined to make the permanent officials more publicly accountable for the spending of their departments. While this is somewhat of a challenge for traditionally anonymous public officials in the Westminster government model, it is ultimately a good thing for both the state and society. Firstly greater transparency of state spending should lead to more efficient use of public funds; through both a greater incentive to prove efficient practices as well as greater opportunities for outsiders to point out inefficiencies to address. Secondly, society should have greater faith in state institutions spending its tax money if it knows how the money is being spent.

Sadly though the PAC seems to be banging its head against oak-panelled committee room walls at the moment in an effort to show incompetence is rife amongst Westminster bureaucrats. It is not. Recently, as an advisor in the thick of it at Westminster, I met many capable public servants whose talents and drive were more often than not frustrated by a system which intrinsically defaults to inertia. So if the PAC really wants to enhance scrutiny it needs to find a smarter mechanism that both incentivises more open information and rewards those who give it competent and credible answers. A mechanism that enables parliamentarians to get even, rather than get mad, so to speak

A former head of the UK civil service often presented his own ‘capability reviews’ to the British Prime Minister as evidence that the permanent bureaucracy were driving their own “improvements”. From what I could understand, relative to how a good business would review itself, these were all about ticking organisational process boxes rather than focusing on the achievement of outcomes. Still, there did seem to be something in the relative rankings; especially how the heads of department defensively reacted when you pointed out their ‘league placing’ compared to another department. Permanent officials, it seems, are highly competitive animals when judged against each other. While of course in public they can all agree on the wine list, in truth nobody would want to be left drinking the merlot!

So, could this point to some innovation for Hodge and Bacon to exploit in their quest to enhance transparency and improve bureaucratic efficiency? Rather than simply grandstanding their frustration with permanent officials (which is certainly not good for your health or long term career prospects in the old fashioned Westminster model!) the PAC could more systematically rank the performance given by each permanent official it cross examines, and keep an updated league table on its website. One doesn’t have to think too hard about the different criteria each committee member could score the permanent accounting officers (who are responsible for value for money in their department) on:

  • Provided clear spending data to the auditors / committee in advance (max 5 points)
  • Answers committee questions clearly and fully (max 5 points)
  • Committee has confidence official is on top of department expenditure (max 5 points)
  • Able to to present evidence to show spending is maximising value-for-money, within the ministerial decisions taken (max 10 points)
  • Demonstrates a credible understanding of future threats and challenges to current spending projections (max 5 points)

So the idea is an ‘accounting officers premier league’. For sure it wouldn’t get much notice beyond the Westminster bubble, but the PAC could be sure that when the heads of department sit round the table together each wednesday morning they will all know who is at the top and who is at the bottom! Could this incentivise senior bureaucrats to up their game in front of Hodge and Bacon, resulting in a more transparent state having to explain more competently the spending taken on behalf of society? You betcha! Will Hodge and Bacon have the courage to try such an innovation when the new parliamentary term starts next week? Well, they are a breath of fresh air providing a much needed kick to the system, but doubt you will see this sort of innovation anytime soon.