Mulgan suggested that, through elevating this organised paranoia into a principle informing policy planning, the government hoped to become better at spotting new risks such as SARS, BSE and bioterrorism ‘before they become evident’. But how exactly do the seers and oracles of Whitehall hope to identify a potential risk before it has even become visible? By gazing into a crystal ball, perhaps?
Almost, it seems. The modern political equivalent of the crystal ball is the ‘what if?’ scenario, and this is increasingly becoming the stuff of policy-planning discussions on both sides of the Atlantic, especially post-9/11. It means that policymakers dream up fantasy disasters (what if a terrorist infected with SARS crashed a petrol tanker into a nuclear power station?), and then try to plan to deal with these hypothetical crises.
The reaction to SARS became a powerful symbol of what is wrong. Here was a new but relatively minor epidemic that, in a sane society, would demand a serious response from the medical and epidemiological authorities.
In our apparently less-than-sane society however, officials from the World Health Organisation (WHO) downwards treated SARS as a cross between the Black Plague and a bioterror attack, quarantining entire cities and damaging whole economies. Meanwhile people across the world could be seen walking around wearing useless paper masks, a sort of modern equivalent of the medieval amulets used to ward off evil. The SARS panic turned into an outstanding example of the cure being worse than the disease, the panic causing more damage in the real world than any fantastic ‘what if?’ scenario is likely to.
Mulgan’s remarks should serve to remind us that the suffocating safety-first spirit of the age comes from the top down. Major political academic and scientific institutions now appear to be obsessed with risk management/avoidance, and infected with the outlook of organised paranoia. The worst fear of those in authority is now to be accused of not taking sufficiently stringent precautions to ward off some potential, or even hypothetical, threat to public health.
The watershed in this came with the BSE/vCJD crisis of the 1990s. The authorities were widely – and arguably unfairly – blamed for not doing enough to foresee and forestall that disaster for British farming. The Phillips Report into the disaster advised that the government should in future adopt a strict ‘precautionary approach’ at the hint of any potential public-health problem. Even though the apocalyptic predictions about a vCJD epidemic on which the Phillips approach was based proved entirely unfounded, the precautionary principle has been institutionalised in government policies ever since. It essentially dictates that a lack of hard evidence about a possible risk is no excuse for postponing official intervention and public-health warnings.
The impact can be seen in something like the government-backed Stewart Inquiry of 1999 into the safety of mobile phones, which established that there no evidence of a health risk – but then concluded that, regardless of the evidence, we should all adopt a precautionary approach to using the things anyway. In 2005, the official UK Food Standards Agency launched a high-profile PR campaign around the alleged risk posed by the Sudan 1 food dye. The presence of traces of the banned colouring in some processed foods (so minute that anybody would need to eat a supermarket full of the stuff to suffer so much as a stomach ache), became the pretext for ordering the recall of millions of pounds’ worth of perfectly edible food. Every expert knew there was no real risk of harm to public health; one put the risk of eating some of the contaminated processed food on a par with smoking one cigarette in an entire lifetime. But they went ahead and banned it anyway, threatening shopkeepers with prison for selling safe food, just as a precaution.
The authorities’ hope is that taking pre-emptive action will reassure the public and forestall future health panics. The result, however, is often the precise opposite. In the risk-conscious climate discussed above, overblown precautionary measures only confirm many people’s suspicions that there is a real problem. And self-conscious government attempts to show that it is doing something can only lead to escalating demands for it to do more.
It is possible to see how this works itself out in relation to the avian-flu issue as it has developed in the UK over the past couple of years. For its part, the New Labour government has tried to hold the line against hysteria and appear reasonable, issuing a consistent ‘don’t panic’ message. But it has been repeatedly outbid by opposition politicians, experts, campaigners and media voices accusing it of complacency or a cover-up, and demanding more and more precautionary measures. In this, it lies at the heart of government policy on everything from food dye to mobile phones, and by emphasising the need to reduce risk. Now, fearful of being accused of not intervening enough to prevent a potential threat to public health (almost the most serious charge a politician can face these days), the government’s response is to up the ante further, to try to demonstrate that it is fully prepared.
There have been many official appeals to remain calm and attempts to put the risk of bird flu in perspective (such as the chief scientist’s assessment that, even if avian flu did infect our poultry population, the odds of anybody in Britain contracting it would be about 100 million to one). But these would be far more convincing if they were not accompanied by reports of the government’s plans to deal with a hypothetical devastating pandemic. These measures include plans to close schools, reportedly to keep the predicted number of deaths among children down to 50,000 instead of 100,000 (that should reassure the parents); plans to dig ‘plague pit-style’ mass graves to accommodate the countless thousands of expected corpses; and plans to give GPs and medical staff armed escorts to beat off the predicted mobs of vaccine-hunting people. It is worth recalling that these are government measures designed to deal with a pandemic to be caused by a strain of the H5N1 subtype of the bird-flu virus that could pass easily from human to human – a strain that does not actually exist anywhere in the world, and may never do so. That is organised paranoia in action. If headless-chicken syndrome were to catch hold of the country in relation to bird flu, the infection will have spread from the top of the body politic downwards.
The confusion over bird flu confirms how the creeping spread of the politics of fear and the rise of risk-aversion makes our society easy prey to any panic in matters of personal health. We have reached the point where we often seem to live in a sort of Chicken Little culture, in which many are predisposed to panic about the sky falling in every time an acorn falls on their head (or a trace of nut appears in their food). Although the sky is not falling on our heads yet, some who should know better do seem to be suffering from clouds on the brain.
There is a crying need for a sober and rational presentation of the facts about health today, to counter the entrepreneurial scaremongers and the professional panic merchants. This book is the place to start. Ultimately winning the arguments, however, will also require waging a culture war against the miserabilist spirit of our times, which provides such a fertile environment for the spread of sick ideas about health, risk and humanity.
PROLOGUE: WHOSE OPINION CAN WE TRUST?
BY STANLEY FELDMAN
AND VINCENT MARKS
We are bombarded with advice on healthy living. If everyone agreed upon a particular formula that would ensure good health and long life we would all sign up for it. Unfortunately, there is no utopian life plan and little unanimity of opinion. As a result we do not know whose opinion to follow and whose to ignore. As a prelude to assessing the value of all this advice, we must consider whose views are sensible and reliable. Whose opinion can we trust?
Frederick II of Germany wrote in the thirteenth century: ‘one ought not to believe anything, save that which can be proven by nature and the force of reason’. His views were echoed in the sixteenth century by the French essayist Montaigne: ‘I would have every man write of that which he knows.’ The implication was that one must distinguish between opinion, which is that which one thinks may be true, and fact. Only fact is a fit basis for promulgating new ideas. The basis of essay writing is to use