This weekend President Obama spoke to high tech computer science audience at the SXSW festival in Austin, Texas. “Government has to tackle harder problems than the private sector”, he told them, adding, “we are at a moment in history when technology, globalisation and our economy are changing so fast”.

He told an enthusiastic audience, “if we [in government] join forces [with you] there is no problem that is not solvable. It is not enough to focus on the next big thing. It is how we harness the next big thing to make sure that everybody in the country has an opportunity.”

And elsewhere we read about the rise of artificial intelligence (AI) and robots, and of the fear that many people in the future will be stuck in a drudge underclass, working to the orders of a computer with AI that answers phones, talks to customers, negotiates with suppliers, solves delivery problems, and spots new trends in the market.

Which isn’t as fanciful as it sounds when we find that, also this weekend, that Google working with DeepMind has produced an AI machine called AlphaGo which has beaten a world-ranking player at Go three times in a row.

Don’t be misled. The use of AI to win games is just a showcase to catch public attention. DeepMind is a very general platform which can be tasked with a wide range of problems to solve and businesses to run. And no doubt with driverless lorries before long.

So, can we use AI to manage programmes in the public sector, the harder challenge?

Yes we can.

The Greater Manchester authorities have big plans to devolve and integrate health and social care. These plans are outlined for public consultation in spring 2016.

To win public support for change, there needs to a clear “offer” with a public convinced that there is no wiggle room for corporate deceit.

The general public mostly knows and understands the current national “offer”:

1. Ambulances with an eight minute target for arrival,
2. A+E with a four hour target for waiting, and
3. GPs with a “days not weeks” target for appointments.

The Greater Manchester “offer” needs to add:
4. a 24/7 pharmacist within five miles,
5. a nurse appointment next working day,
6. a home accidents prevention visit within two working days,
7. a home care assessment and named care manager within five working days,
8. a quality-controlled network of home care providers, and
9. a quality-controlled training network for front-line staff and volunteers.

Guarantees. No disappointing small print, and sanctions for any manager who tries to game the system.

Details

The devolution aims are very good, though beyond five years we should aim to exceed the England averages in all categories. Clearly the strategy is right to say that poverty is a root cause of chronic ill health, though the section on early years development needs more detail, especially for parents with low pay and long hours. Also, there are some areas in health care where the English average is woefully short of the European average, especially in the early detection of cancers. An improvement here will probably require more routine community-based blood testing.

But my main comment is the need to engage the public attention of 2.5m people. The GP and hospital services are clearly understood. Councils less so. Trust in change is low and anxiety is high. Leaflets with initials and long, vague phrases will miss people entirely, except to fuel suspicion.

Of course there will be a public engagement strategy with an exhibition trailer and leaflets to take around town centres, with local radio programmes and newspaper reports. But the content, the “offer” is key, otherwise it risks adding to a general public perception that change cannot be trusted and clever lies will cover the truth. In general, politicians who go on the doorstep at election time probably get this sense of public suspicion more than their staff do, and especially more than some senior staff who are without shop-floor, daily public-serving experiences.

So the devolution of health and social care allows for some fresh thinking

For example, a target of a 24/7 pharmacist within five miles of everyone in Greater Manchester. Some of these could be based within all-night petrol stations. They have ease of access, security, and the safety of existing staff. It would be a source of advice, not just emergency supplies, and would look at sustained health promotion for shift workers and for drivers with long hours. It would play a strong role in promoting men’s health. For security only a limited amount of controlled drugs would be kept, in a time-delay safe.

A pool of salaried pharmacists would be employed to provide a mixed economy of provision and to mitigate the procurement tendency of cartels and of some contractors using service guarantees to push up price negotiations.

For nurse appointments, in other European countries it is common to make such a booking by using a phone app. Even on the outlying islands. We should catch up.

Of course, not every beneficial change can be summarised in a target or clear promise. The role of poverty in determining overall health was covered above. Another key factor is the importance of mental health, and including here substance abuse and addictions, especially alcohol misuse.

Many people have direct or family experiences of living with mental health distress or with addiction-dominated lifestyles. This happens in all walks of life, and at all ages. It is often a great strain on families, and even harder to cope with alone. Too often, impossible. This personal understanding from experience, a rich vein of knowledge running through society, needs to be supported and harnessed.

The need for community support is widely understood, but the means to build that support are not always available. The Greater Manchester devolution of health and social care could make a big difference here.

As practical examples, a programme would include:

A mental health first aiders course for front-line staff (including housing, fire and rescue, transport and especially rail, libraries, schools, custody) and for youth, community and voluntary groups (guides and scouts, sport and leisure, neighbourhood and residents).

A longer course in approaches to addiction reduction would be available for front-line staff and volunteers who form longer term relationships with service users and fellow members. Training providers would be quality assured before they could use the Greater Manchester NHS brand.

These programmes would build on the national and international centres of expertise in mental health in Greater Manchester, such as 42nd Street, the Hearing Voices Network, and innovative work supporting the mental health of refugee and displaced children.

Buildings

The hospital “estate” also needs some creative change. The need to move away from reactive admissions towards community-based prevention and treatment is understood and highly desirable. Nevertheless, people have a heart-felt connection to their local hospital where their have stayed, where their children were born, where their relatives died. Local hospitals could become more varied, for example with fewer rooms needed for reactive treatment and the rest used as studio space for artists, as repair workshops for recycling groups, as college training rooms and as community function rooms.

Home care is probably the most fraught topic here

Over the years it has become increasingly difficult. Lawyers have left their mark. The laws of thirty years ago – the Council shall provide – has been worn down over the years with case law replacing a person’s absolute right to receive home care with vaguer phrases such as – the Council shall endeavour to provide. To some extent people mostly with the highest levels of need were able to side-step their Council by going to the national Independent Living Fund (ILF) which created a wealth of best practice in person-centred home care. The development of Direct Payments as an alternative to Council provision was an attempt to mainstream some of the ILF principles. But years of financial cuts have reduced this provision, to just a history lesson.

Councils are in the invidious position of being told to pick up the pieces but with less money, and people using those services only have a time-limited protection within Council provision. The time will soon run out, as will the money. Government promises to make a lifetime cap on people’s own financial contributions to their care costs have been kicked into the long grass, put off for years to come. Meanwhile Councils look into bank accounts now and use the law to seize the value of people’s houses which can be sold later. It was becoming true that home care was for the poor and the rich, but not for people in the middle. However, with recent benefit changes, mostly around Housing Benefit (such as the weekly cap, increases in affordable rents, bedroom occupancy limits) the scope for poor people to survive on benefits with home care is increasingly hard to achieve.

So, the hardest test for devolution in Greater Manchester will very probably be to what extent a new local arrangement can mitigate against the worst of these cuts. To date, the system has been first to change the criteria, then to only fund those who meet the highest criteria, and to means-test all provision regardless of people needing modest savings to protect their wellbeing, such as saving to build a downstairs bathroom.

We saw in the devolved arrangements in Scotland how the promise of free social care for elderly people was rationed out in practice by creating long waiting lists for assessment. It is this type of practice which is seen by people as deceitful and it feeds distrust in politics and in what claims to be the democratic process.

We must have honest conversations with people

“Your home care assessment is for three hours support each day to help you with washing, dressing, eating, whatever. Your elderly parent can do some of this, and the Council can provide the staff or money for two hours a day of this. It isn’t ideal, and thousands are in the same boat as you and there is no spare money. But given this, what would you want us to provide first?”

You might say, start with anything involving heavy lifting. And then, give my parent each Tuesday off. Or whatever.

And the stark reality is, due to lack of funds, you can only go out twice a week, and it is only because the doctor has agreed to do home visits that these can include social trips as well as health appointments. But this is a more honest approach than creating new waiting lists to hide the numbers and pretending everything in home care is better than people know it is.

Predicting and creating the future are two sides of the same coin. We need to, if not predict, then to imagine and describe the future we want to create. Better jobs, a cleaner city, more local people in employment – these describe the what, but not the how.

The ‘how’ of urban regeneration is changing. Property-led growth in urban land values, fuelled by international capital flows, is reaching its limit. London is thought to still have room for further growth, but the inequality strain will snap at some point soon, and other UK cities have already peaked.

A market correction / crisis is widely expected, but investor sentiment always believes it will ride the wave and happily bail just before the peak falls. Saying there is froth in the market actually encourages them in, believing they will outwit other naive people.

So, beyond relying on double-digit rising land values into the future, what is the strategy now?

To some extent, the strategy to date has been post-rationalised. In Manchester it was music – Factory Records – and lofts in and around the gay village – Urban Splash – and visual culture – Granada TV – that made the city centre “vibrant” again, a word that is now estate agents code for public drunkenness. The money saw the Manchester urban wave growing, but it didn’t create it.

The recipe for urban renewal has some general ingredients – youth, risk, questioning, a constantly-new mix of cultures, room to fail and start again anyway, and shoestring ways of taking a punt. Manchester adds a powerful tolerance for diversity and difference, usually, though recent trends are a worry. Angela Merkel is the political leader best showing tolerance between communities currently.

The Victorians pretty much invented the modern city government, even as they ignored heritage. The Romans only cared for roads and water courses, and these days we are becoming more Roman than Victorian.

Public libraries, swimming baths, clean water, parks, housing standards, school boards and inspectors, tramways, and the like. Who is now re-inventing local government for our age? The fundamentals of health, of education, of working environments, of housing, of culture, need a visionary creative group of people to think – how shall we all do this now? Devolution is a good start, but it is about working the old model a bit better, fewer internal contradictions, etc.

We need to devolve the old, but more importantly we need to evolve our new. Original. Modern.

This month, January 2016, includes a new legal right, that every single-deck buses in use in the UK must have a ramp and a space for a wheelchair user. This legal right helps elderly people and adults with buggies as well. The same change will happen for double-deck buses next year, and coaches will follow.

This new legal right comes from a law passed by the EU in 2001 with a phasing-in timetable. First, all new buses had to be accessible. And now it is becoming all buses, new and old.

This campaign took over six years to change EU law, and some would say it took 20 years if you measure from the International Year of Disabled People in 1981. There is a free case study on the EU campaign for accessible buses, below.

Disclosure: I was involved in this EU campaign.

Further details:

http://www.transportforall.org.uk/news/from-january-all-single-decker-buses-must-be-accessible-to-wheelchair-users

https://tonybaldwinson.wordpress.com/2013/09/09/book-buses-for-all-europe-a-case-study-in-changing-eu-law/

A human rights social enterprise in Bradford has developed a new algorithm which can analyse satellite pictures from war zones and show the world where those missiles have been launched from.

See their site – https://rudiment.info/projects/arcade

Up to now, hostile forces could camouflage their missile launch sites from satellites and so deny any responsibility for civilian casualties. But they cannot disguise the damage the missiles do when they hit their targets. By analysis of the craters left behind, and some clever CSI-type calculations, the new ARCADE program will point the finger at the guilty parties. No longer can a government or insurgents get away with denying responsibility for missile attacks against people inside or outside a country.

I worked in Bradford in 2015 on an EU-funded project at the university re:centre to help small enterprises. I was very pleased that we could support this Rudiment social enterprise in its development. A truly worthwhile enterprise.

Well, my over-riding memory of being at UMIST was just how very international it was. Unlike most other universities in England which were very mono-cultural, at least in our eyes.

UMIST was where I went to university in the late 1970s in Manchester. Many years later it merged with the University of Manchester which is nearby. Or was taken over, depending on your point of view. Now the ‘old UMIST’ campus is to be sold off as prime city centre land, earmarked for tower blocks of student housing. The word is consolidation.

Not so many years ago I tried to get a library ticket at the university after the merger. I was an alumni I told them. Ah yes, they said, but only UMIST alumni, so no free ticket. To be fair, that rule has changed.

And now the university is running a small project to try and preserve the memories and meanings of UMIST, asking on LinkedIn for nostalgic postings on what UMIST meant to its former students and staff. Well, some thoughts…

Of course, these days every university is chasing the overseas market and their fees. And even back in the day, post-graduate students in many places were from more diverse backgrounds than the undergraduates. But UMIST stood out as being highly international at all levels.

My extra-curricula interests ranged from the Socialist Society to Community Action, becoming the elected Welfare Officer with a sabbatical year after my graduation. The debates in the Students Union were wide-ranging, well informed, and keenly felt. The Iraq-Iran war directly affected people’s families and home towns. The ethnic Chinese students with families in Singapore knew what colonialism meant.

More recently I worked for the University of Salford, and curiously its high level of diversity amongst undergraduates was a pleasing reminder of the culture of UMIST.

I guess my point is, that notwithstanding all the marketing requirements that universities now have to never admit any weakness, it would be intellectually and personally satisfying to see some measure of recognition of the strength that was UMIST’s international culture.

You might think that newer buildings would be better for disabled people than older buildings. Better access. Easier movement inside. More ramps and fewer steps, and so on. So why, increasingly, does it not feel like that when you actually visit a new building?

The devil is in the detail
The details of building design are controlled by the Building Regulations, through a process called Building Control. This process is different to Planning Permission, which looks at the outside design and how it looks to passers-by, the impact of parking on neighbours, and so on. The Building Regulations control what goes on inside. For example, making sure that the electricity sockets are safely away from any water taps, or that the bannisters are close enough together so that a toddler cannot fall downstairs through a gap.

Computer says OK
A few years ago the Government at the time gave into pressure from businesses for less red tape, less regulation, less burden on business as they claimed. Up to then, Building Control was something that the local council did, usually on the same corridor as Planning Permission. Well, said business, let us do our own Building Control. Don’t worry, they said, we will hire independent professionals, so we are not marking our own homework. And the Government let it happen.

Two bad changes then followed, one cultural and one technical. The cultural change is that the independent professionals challenge less often than a council official would, because they need the work, the next contract. It is a world of hire and fire. And the technical change is, to save money, that building designers use computer programs more often. So the computer counts up the turning circles and the accessible toilets, checks the ramp gradients and gives the design a green light. Even if it makes no sense to humans.

The result too often is, for disabled people, new buildings that are increasingly chaotic and hostile.

The emphasis on a rolling news agenda, on 24/7 coverage, is producing some silly journalism such as the above headline this week broadcast on a respected news website.

Ah, but we are told, journalism is different now. It’s not like the old days of newspaper deadlines only once or twice a day. Well, up to a point. Remember, in the old days there was a Stop Press column for breaking news. But the journalism back then would say, “Major Earthquake in x. Many feared dead.”

And this is the point. In the early stages we need information and intelligence, not silly numbers. You can almost imagine the scene, the frantic phone call from duty editors in London to the nearest office of a news organisation – “Look out the window! How many are dead? A bus has just crashed outside? Great! Six dead, must be! Get me pictures! Shaking buildings, falling bridges! (hangs up)”.

I’d like to think we can do better than this next time. In the early stages after such a disaster we need intelligence. You would want to hear from a competent seismologist – what kind of area is it? Usually remote, but where are the populations? Then, what is the local health infrastructure like? What might be the likely physical aftermath in that region – flooding, landslips, aftershocks, crop losses, what are the night-time temperatures outdoors for the next month?

Later that day, maybe something on the local politics. What level of resources do the authorities have, and what competences do they have in deploying those resources effectively? Are humanitarian organisations in the area, and frankly what are their competences too?

Journalism, please, not instant daft numbers.

We read a lot about the dangers of social media. That people now get their news “in a bubble” from like-minded people. That opposing views and objectivity are lost. What does this mean for journalism?

Well, firstly let’s not kid ourselves – newspapers can be just as much a bubble machine as social media. Would a teenager read the Daily Express? Would a socialist read the Daily Telegraph? The newspaper with possibly the broadest demographic appeal (but not sales) is arguably the Financial Times, being read by billionaires and trade union shop stewards everywhere.

But, the argument continues, journalism has certain standards. Truthfulness, honesty, integrity, accuracy. Speaking truth to power. The cub reporter on the local newspaper faithfully reporting from the Magistrates Court. And in some newspapers it was possible to ignore their leader articles and commentary and focus on the hard news, reported well. Of course, phone hacking has left its mark, even though the public perception is that it was mostly the fault of tabloids.

Blagging has always been a necessary tool for the investigative journalist, getting past a switchboard or a reception desk to gather information or confront a wrong-doer. It is interesting that many such investigations now post video alongside the story. News editors know that we sometimes will only believe what we see, no longer what we are told, and that in an age of skimming and multiple screens we gaze at pictures more than we readparagraphs.

Hence the argument for quality news and public broadcasting, like the BBC. It is meant to be our village water well, where everyone meets to talk, listen, learn, argue. Where there is no bubble, no sub-group, no hidden agenda.

But the BBC and its ilk are competition for newspapers, who also face competition from “free” social media. Essentially this is about how advertising has gone online, leaving newspapers behind. Advertising was always a substantial source of income for newspapers, from the houses-for-sale in the local paper to the fancy cars in the nationals. But Google and Facebook and Twitter are where the advertising money is now being spend, so that you see “sponsored” and “promoted” selling items inserted between the real stuff by real people.

In a market economy, one of the roles of taxes (and laws) is to promote social goods which the self-interested market, left to itself, would fail to produce. Stopping pollution is one example. Educating the workforce is another.

So, just a thought, but why not tax online advertising (beyond VAT) to fund the social good it threatens to destroy, namely a non-bubble, no-ads unpartisan sources of quality news? There could even be subsidies (tax allowances) for local newspapers with a decent amount of news coverage.

I guess the answer is that the struggling newspapers, trying to move online themselves and grab people’s time away from Facebook, would kick off against it. But somehow we have to find a way to tax the internet’s revenues, as well as trying to fairly tax the offshore internet companies themselves.