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29 January 2001

It’s all a mugger’s game now

Targets, checklists, even extra cash, may not help the NHS and the police. They were just not design

By Jeremy Seabrook

On the day before New Year’s Eve, my partner came home at about 6.30pm, his face, hair and clothes streaked with blood. There was a gash on his head, his ear was torn, his eyes were swollen and bruised.

A common enough occurrence. He had parked off the high street to do some shopping. A dark side street, paces quickening behind him, then a sudden blow to the head from a baseball bat that knocked him to the ground. He was kicked and, as he fumbled for his wallet, was hit again and again. The assailant took a credit card and about £60 in cash.

We went by minicab to the hospital. Being early Saturday evening, the usual late-night wreckage of accidents, fights, woundings and domestic violence had not yet shown up. The staff, sympathetic and considerate, dealt efficiently with the injuries. The wounds were stitched, the tetanus injection given, antibiotics and painkillers prescribed. The hospital staff even telephoned the bank to stop the credit card. The police showed similar courtesy; a call from the police station at 6am on New Year’s Day expressed concern for his “well-being”. They took a statement and showed every sign of zeal in pursuit of the attacker.

Everything that is said about the after-effects of being mugged was confirmed: familiar places are suddenly fraught with menace; you look warily at all passers-by, and view them only in the light of any threat they may pose to you; you avoid all encounters – whether with beggars or people simply asking directions.

The most obvious lesson from this grim episode was not the efficiency or humanity of the official agencies, although those qualities were also gratifyingly apparent. What became clear was the impossibility of the tasks that both the health service and the police are now expected to undertake. The social costs of our version of the better life seem, like the wealth-creating process itself, to be beyond control.

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The health service, set up after the convulsions of war, opened up new possibilities for healing and caring. It would deal with the legacy of long-term industrial neglect, the injuries and untreated disorders, as well as dedicate itself to the alleviation of pain and the cure of known diseases. What it could never have foreseen, and what it was neither designed nor adapted for, was the intensity of the violence inflicted by people on each other in the contemporary world, the culture of the knife, and increasingly of the gun, the injuries and addictions, the drug-dependent frenzy, the racist brutalities, let alone road accidents and all the other mishaps of advanced technology, including the nameless sicknesses generated by the pollutants and toxins that come with economic progress. But perhaps the most intractable of the (then) unforeseeable malignancies has been the end of collective hope for social improvement: this is what has provoked the despairing to seek individual remedies for their socially created dispossession. That means crime. Sometimes, it seems, the horrors of war have been reproduced in a world made safe for democracy – but not, apparently, for human beings.

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Second, the police are also being asked to deal with forms of wrongdoing unanticipated in an archaic, collectivist past. We look for administrative answers to moral and social problems. The instruments of law are called upon to deal with disorders that simply do not respond to the machinery available. Their roots lie elsewhere, in social relationships and values. The frustration and anger of health workers and police alike reflect that what is expected of them is beyond their competence and power; and the crisis of recruitment, the loss of personnel in both services, is a distant response to this largely unarticulated issue.

Politicians who are voluble about both health and law and order are silent on the reality that the aims demanded of the mechanisms employed to “deliver” them cannot be achieved. The industrialising of all social institutions, even those concerned with the social, moral and spiritual condition of the people, serves only to underline the mismatch between rhetoric and reality.

The pathologies of the age scarcely respond to input, investment, processes and outcomes. It may be that even the virtues of “public spending”, that last benign policy instrument of the left, are no longer effective in making good the destruction wreaked by the privatisation of everything, including social hope, now fragmented in the random benefits distributed by Lady Luck: the winning combination, the turn of the wheel, the luck of the draw.

Discussions about numbers of police or nurses, the rates of pay required to attract and retain staff, the imposition of bureaucratic duties upon those in the front line, the targets, checklists, regulatory authorities, task forces, hit squads and all the other paraphernalia of efficiency, seem to suggest that everything can still be comfortably contained within existing arrangements. That this may no longer be so is a possibility against which we must protect ourselves more securely than against the rage and the maladies of our time. How much money would be needed to make the streets safe in a world where insecurity and growing inequality are part and parcel of the mysteries of wealth creation itself? What resources – and what kind of resources – would be required to lift from the people the value-added stress, anxiety, depression, anger and violence that accompany our gilded ill-being?

In this context, the strain on medical and law-enforcement systems cannot be adequately addressed. When all alternatives have been annulled, and vociferously, it becomes necessary to deny that the source of social dislocation and breakdown is deeper than anything likely to be addressed by policy options or manifesto commitments.

Tony Blair once made much of being tough on the causes of crime. If he no longer mentions such things, it is because he has recognised that they are beyond his reach.

This dilemma emerges obliquely in the fascination that hospital and police dramas on TV exercise over people: such efforts to recast socially produced evils in terms of individual stories are attempts to make them more intelligible – to reassure us that somebody is on the case, and that all wrongs are ultimately a question of funding, nothing that cannot be dealt with by the cash injection, increased investment, more resources.

Furthermore, almost every news bulletin contains an item on some spectacular piece of technology that will prolong life, relieve suffering or ease the detection of criminals. The domestication of these issues is calculated to put off the need to confront profound wrongs and injuries, from which even the wealthiest societies are unable to shield their increasingly sceptical peoples.

Sometimes, it takes only a small event to rouse our somnolent senses to the depths of disorder in which we are required to make our home.

Which brings us back to an individual drama that is also part of the great social upheavals of the time.

A banal incident, but it leads swiftly to a crisis of faith in a system and its capacity to deliver, not merely health and security, but all the other basic, easily answered needs of humanity which have been impaired by a dedication to money so complete that more and more people are prepared to maim, injure and kill in its sacred name.