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Where would you rather live: small-government Somalia or big-government Sweden?

Critics of “big government” talk as if it’s beyond question that the state’s involvement with our lives is a bad thing.

Whisper it quietly, but I quite like big government. These days, it’s unfashionable to say so. From New Labour to Blue Labour, from compassionate conservatives to neoconservatives, the consensus is that big government is bad government: slow, inefficient, intrusive, bureaucratic, overbearing, anti-democratic and anti-growth.

“The era of big government is over,” President Bill Clinton (Democrat) declared in January 1996. Conservatives rejoiced. But guess what? By September 2008, big government was back. “We must act now,” announced President George W Bush (Republican), as he unveiled his $700bn bank bailout plan. This champion of free markets went on to bail out the auto industry and, in effect, nationalise the mortgage lenders Fannie Mae and Freddie Mac.

Here in the UK, as the former chancellor Alistair Darling revealed in his memoir, it was big government that prevented cash machines from being switched off and cheques being torn up. Banks were nationalised; multibillion-pound loans and guarantees were offered.

So, why this disconnect between rhetoric and reality? Why this constant railing against the positive power of collective action? The public doesn’t like big government, say fans of . . . small government.

Yet how else to explain our ongoing love affair with the (scandal-ridden) National Health Service, which in its structure and funding is big government pure and simple? Why else are so many of the people whom voters tell pollsters they admire most – doctors, nurses, teachers, soldiers, the police – usually employees of big government?

Not yet convinced? Polls also show significant public backing for the renationalisation of the railways. And not just the railways: a 2009 poll found two out of three voters supported taking the electricity, gas, water and telecommunications industries back into public ownership. (Come back, Michael Foot – all is forgiven.)

Small-government supporters claim that countries with high levels of public spending grow more slowly. Yet, as the Columbia University economist Xavier X Sala-i-Martin concluded in his 1997 study I Just Ran Four Million Regressions, “no measure of government spending . . . appears to affect growth in a significant way”.

In his 2004 book Growing Public, the University of California economist Peter Lindert agrees – countries with high levels of government spending don’t perform any worse than countries with low levels of government spending.

But doesn’t big government crowd out the private sector? Stifle free enterprise and innovation? Not necessarily. Consider the arguments of Mariana Mazzucato, the Sussex University economist and author of The Entrepreneurial State. “Where would Google be today without the state-funded investments in the internet, and without the US National Science Foundation grant that funded the discovery of its own algorithm?” she wrote in the Guardian in April 2012. “Would the iPad be so successful without the state-funded innovations in communication technologies, GPS and touchscreen display?

“Where would GSK and Pfizer be without the $600bn the US National Institutes of Health has put into research that has led to 75 per cent of the most innovative new drugs in the last decade?”

Critics of big government say it crushes community spirit and civic engagement. Again, the empirical evidence suggests otherwise. “Among the advanced western democracies, social trust and group membership are, if anything, positively correlated with the size of government,” the Harvard academic Robert Putnam observed in his acclaimed book Bowling Alone (1995). “[S]ocial capital appears to be highest of all in the big-spending welfare states of Scandinavia,” he wrote.

Ah yes, Scandinavia. Despite having, I accept, much smaller and more cohesive societies than the US or the UK, the highspending, high-growth Nordic nations continue to baffle and frustrate Anglo-Saxon small-staters. Take the UN’s first ever World Happiness league table in 2012: Denmark, where government spending accounts for 58 per cent of national income, topped the list, followed by Finland (54 per cent) and Norway (44 per cent).

Here in the UK, public spending may have peaked at 50.8 per cent of GDP in 2009, in the wake of the bank bailouts, but since 2010 the austerians of the Conservative-led coalition have been cutting spending year on year. Using the latest IMF figures, Peter Taylor-Gooby, a professor of social policy at the University of Kent, has calculated that by 2017 government spending, as a proportion of GDP, will be lower in the UK than in the United States – 39.1 per cent to 39.3 per cent – for the first time since records began. “I was astounded,” Taylor-Gooby tells me. “Even after the First World War, and the round of cuts then, we didn’t go this far.”

Meanwhile, those who pine for a leaner, meaner, smaller state cannot answer the simplest question: how would small government have paid for the bailout of RBS, Lloyds and the rest? The Treasury has coughed up roughly £850bn to prop up the UK’s financial sector, according to the National Audit Office. Can small government tackle the threat of runaway climate change and the rising costs of adaptation and mitigation? It is forecast that the global warming bill will run into trillions of pounds. It may be fashionable to want to roll back the state, but ask yourself this: where would you rather live, “big-government” Sweden or “small-government” Somalia?

Mehdi Hasan is a contributing writer for the New Statesman and the political director of the Huffington Post UK, where this column is crossposted

Mehdi Hasan is a contributing writer for the New Statesman and the co-author of Ed: The Milibands and the Making of a Labour Leader. He was the New Statesman's senior editor (politics) from 2009-12.

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“I felt so frantic I couldn’t see my screen”: why aren’t we taking mental health sick days?

Some employees with mental health problems fake reasons for taking days off, or struggle in regardless. What should companies be doing differently?

“I would go to the loo and just cry my eyes out. And sometimes colleagues could hear me. Then I would just go back to my desk as if nothing had happened. And, of course, no one would say anything because I would hide it as well as I could.”

How many times have you heard sobbing through a work toilet door – or been the person in the cubicle?

Jaabir Ramlugon is a 31-year-old living in north London. He worked in IT for four years, and began having to take time off for depressive episodes after starting at his company in 2012. He was eventually diagnosed with borderline personality disorder last January.

At first, he would not tell his employers or colleagues why he was taking time off.

“I was at the point where I was in tears going to work on the train, and in tears coming back,” he recalls. “Some days, I just felt such a feeling of dread about going into work that I just physically couldn’t get up ... I wouldn’t mention my mental health; I would just say that my asthma was flaring up initially.”

It wasn’t until Ramlugon was signed off for a couple of months after a suicide attempt that he told his company what he was going through. Before that, a “culture of presenteeism” at his work – and his feeling that he was “bunking off” because there was “nothing physically wrong” – made him reluctant to tell the truth about his condition.

“I already felt pretty low in my self-esteem; the way they treated me amplified that”

Eventually, he was dismissed by his company via a letter describing him as a “huge burden” and accusing him of “affecting” its business. He was given a dismissal package, but feels an alternative role or working hours – a plan for a gradual return to work – would have been more supportive.

“I already felt pretty low in my self-esteem. The way they treated me definitely amplified that, especially with the language that they used. The letter was quite nasty because it talked about me being a huge burden to the company.”

Ramlugon is not alone. Over three in ten employees say they have experienced mental health problems while in employment, according to the Chartered Institute of Personnel and Development. Under half (43 per cent) disclose their problem to their employer, and under half (46 per cent) say their organisation supports staff with mental health problems well.

I’ve spoken to a number of employees in different workplaces who have had varying experiences of suffering from mental ill health at work.

***

Taking mental health days off sick hit the headlines after an encouraging message from a CEO to his employee went viral. Madalyn Parker, a web developer, informed her colleagues in an out-of-office message that she would be taking “today and tomorrow to focus on my mental health – hopefully I’ll be back next week refreshed and back to 100 per cent”.

Her boss Ben Congleton’s reply, which was shared tens of thousands of times, personally thanked her – saying it’s “an example to us all” to “cut through the stigma so we can bring our whole selves to work”.

“Thank you for sending emails like this,” he wrote. “Every time you do, I use it as a reminder of the importance of using sick days for mental health – I can’t believe this is not standard practice at all organisations.”


Congleton went on to to write an article entitled “It’s 2017 and Mental Health is still an issue in the workplace”, arguing that organisations need to catch up:

“It’s 2017. We are in a knowledge economy. Our jobs require us to execute at peak mental performance. When an athlete is injured they sit on the bench and recover. Let’s get rid of the idea that somehow the brain is different.”

But not all companies are as understanding.

In an investigation published last week, Channel 5 News found that the number of police officers taking sick days for poor mental health has doubled in six years. “When I did disclose that I was unwell, I had some dreadful experiences,” one retired detective constable said in the report. “On one occasion, I was told, ‘When you’re feeling down, just think of your daughters’. My colleagues were brilliant; the force was not.”

“One day I felt so frantic I couldn’t see my screen”

One twenty-something who works at a newspaper echoes this frustration at the lack of support from the top. “There is absolutely no mental health provision here,” they tell me. “HR are worse than useless. It all depends on your personal relationships with colleagues.”

“I was friends with my boss so I felt I could tell him,” they add. “I took a day off because of anxiety and explained what it was to my boss afterwards. But that wouldn’t be my blanket approach to it – I don’t think I’d tell my new boss [at the same company], for instance. I have definitely been to work feeling awful because if I didn’t, it wouldn’t get done.”

Presenteeism is a rising problem in the UK. Last year, British workers took an average of 4.3 days off work due to illness – the lowest number since records began. I hear from many interviewees that they feel guilty taking a day off for a physical illness, which makes it much harder to take a mental health day off.

“I felt a definite pressure to be always keen as a young high-flyer and there were a lot of big personalities and a lot of bitchiness about colleagues,” one woman in her twenties who works in media tells me. “We were only a small team and my colleague was always being reprimanded for being workshy and late, so I didn’t want to drag the side down.”

Diagnosed with borderline personality disorder, which was then changed to anxiety and depression, she didn’t tell her work about her illness. “Sometimes I struggled to go to work when I was really sick. And my performance was fine. I remember constantly sitting there sort of eyeballing everyone in mild amusement that I was hiding in plain sight. This was, at the time, vaguely funny for me. Not much else was.

“One day I just felt so frantic I couldn’t see my screen so I locked myself in the bathroom for a bit then went home, telling everyone I had a stomach bug so had to miss half the day,” she tells me. “I didn’t go in the next day either and concocted some elaborate story when I came back.”

Although she has had treatment and moved jobs successfully since, she has never told her work the real reason for her time off.

“In a small company you don’t have a confidential person to turn to; everyone knows everyone.”

“We want employers to treat physical and mental health problems as equally valid reasons for time off sick,” says Emma Mamo, head of workplace wellbeing at the mental health charity Mind. “Staff who need to take time off work because of stress and depression should be treated the same as those who take days off for physical health problems, such as back or neck pain.”

She says that categorising a day off as a “mental health sick day” is unhelpful, because it could “undermine the severity and impact a mental health problem can have on someone’s day-to-day activities, and creates an artificial separation between mental and physical health.”

Instead, employers should take advice from charities like Mind on how to make the mental health of their employees an organisational priority. They can offer workplace initiatives like Employee Assistance Programmes (which help staff with personal and work-related problems affecting their wellbeing), flexible working hours, and clear and supportive line management.

“I returned to work gradually, under the guidance of my head of department, doctors and HR,” one journalist from Hertfordshire, who had to take three months off for her second anorexia inpatient admission, tells me. “I was immensely lucky in that my line manager, head of department and HR department were extremely understanding and told me to take as much time as I needed.”

“They didnt make me feel embarrassed or ashamed – such feelings came from myself”

“They knew that mental health – along with my anorexia I had severe depression – was the real reason I was off work ... I felt that my workplace handled my case in an exemplary manner. It was organised and professional and I wasn’t made to feel embarrassed or ashamed from them – such feelings came from myself.”

But she still at times felt “flaky”, “pathetic” and “inefficient”, despite her organisation’s good attitude. Indeed, many I speak to say general attitudes have to change in order for people to feel comfortable about disclosing conditions to even the closest friends and family, let alone a boss.

“There are levels of pride,” says one man in his thirties who hid his addiction while at work. “You know you’re a mess, but society dictates you should be functioning.” He says this makes it hard to have “the mental courage” to broach this with your employer. “Especially in a small company – you don’t have a confidential person to turn to. Everyone knows everyone.”

“But you can’t expect companies to deal with it properly when it’s dealt with so poorly in society as it is,” he adds. “It’s massively stigmatised, so of course it’s going to be within companies as well. I think there has to be a lot more done generally to make it not seem like it’s such a big personal failing to become mentally ill. Companies need direction; it’s not an easy thing to deal with.”

Until we live in a society where it feels as natural taking a day off for feeling mentally unwell as it does for the flu, companies will have to step up. It is, after all, in their interest to have their staff performing well. When around one in four people in Britain experience mental ill health each year, it’s not a problem they can afford to ignore.

If your manager doesn’t create the space for you to be able to talk about wellbeing, it can be more difficult to start this dialogue. It depends on the relationship you have with your manager, but if you have a good relationship and trust them, then you could meet them one-to-one to discuss what’s going on.

Having someone from HR present will make the meeting more formal, and normally wouldn’t be necessary in the first instance. But if you didn’t get anywhere with the first meeting then it might be a sensible next step.

If you still feel as though you’re not getting the support you need, contact Acas or Mind's legal line on 0300 466 6463.

Anoosh Chakelian is senior writer at the New Statesman.