Thatcher’s Alcohol Legacy Part 2: The New Public Health

But she definitely said it. At least twice: in a 1987 interview with Woman’s Own​ and then a year later in a statement to the Sunday Times​ (same link, see appendix). So she must have meant it. But meant what?

The context of the Woman’s Own interview makes it clear that she was making a point that’s in vogue today:

“I think we have gone through a period when too many children and people have been given to understand ‘I have a problem, it is the Government’s job to cope with it!’… so they are casting their problems on society and who is society? There is no such thing. There are individual men and women and there are families…”

She goes on to talk about state benefits and claim “there are some people who have been manipulating the system”. Iain Duncan Smith, then, is going over old ground. The ‘problem’, it seems, goes back at least 25 years, and so does the solution – to somehow get people to take individual responsibilty.

I was going to say ‘Tory solution’ but of course the ‘rights and responsibilities’ shtick was a strong theme of the Tony Blair government and it’s probably there with Ed Miliband. Though nobody can be quite sure.

As previously noted​, Thatcher’s absent society has a lot in common with David Cameron’s Big Society. The difference is that the Big Society adds ‘community’ to Thatcher’s individuals and families.

Earlier this year the Demos thinktank produced a document titled Control Shift​ which included proposals “designed to promote the rebalancing of risk and responsibility, focusing policy on shifting control from the state to individuals and communities”.

Its press release​, picked up by the mainstream media, homed in on one proposal – that people who make healthier choices should jump queues for hospital treatment. Or, to put it another way, if you drink too much, smoke too much or eat too much you must go to the back of the line. Unless you can afford to go private, of course.

Degrees of nudge​
This is an example of ‘nudge-plus’, an aggressive form of the ‘nudge’ by which, as this fashionable theory goes, people are encouraged to behave in ways that will relieve the burden on the state and make everything simply lovely.

In milder forms this tactic is evident in the efforts of both medical temperance and the drinks industry to moderate consumption. The former by making it harder for people to buy alcohol, the latter by educating people about units, and so on. They are two different degrees of nudge.

Underlying nudge theory is the failure of the liberal conception of a rational economy based on individuals acting consistently in their own interests. It fails because human beings are as much emotional as rational, and because they are not individuals in any meaningful sense, but born into a society.

The liberal political philosophy that has dominated capitalist society for hundreds of years is continually frustrated by the intransigence of humans, and at the time Thatcher reached office an era of economic crisis had given that frustration, and the desire to “rebalance” responsibilities between individual and state, a fresh urgency.

It’s no coincidence that the so-called ‘new public health’ approach, in the version brought to alcohol policy by Kettil Bruun​, gained credibility and favour during the Thatcher era.

They may not have agreed on the form of nudge, but Bruun’s big idea, to reduce alcohol harm by reducing its availablity, results from the same contradiction and frustration that Thatcher wrestled with in her Woman’s Own interview, and it continues to drive alcohol policy debates today.

Read part one, on the Beer Orders.