Monday 30 March 2020

Supersize Institutions vs Coronavirus

The principal objective of most coronavirus strategies across the world is to limit the collapse of institutions of health. It is obvious that the effort to protect one giant institution puts other giant institutions at risk. Government itself fears for its future, as politicians go to great pains to claim how "well" they are doing in the crisis: the risk here is loss of public trust. Collapse of the health system would produce catastrophic death rates and the potential for social breakdown. Businesses large and small also feeling the full force of the crisis.

Educational institutions will not be far behind. While moving teaching online has been the emergency measure, it is unlikely that traditional institutions of education can maintain their integrity divorced from the campus on which they established their history, reputation and (more recently) capital investments.

While it is tempting to view this as an environmental crisis which simply blows away everything in its path, such a view is dangerous. It opens the door to authoritarianism where Viktor Orban figures will demand total "control" to do the will of the people while really serving selfish interests. This too is a consequence of institutional crisis. The weaknesses in our institutional fabric have been obvious for decades. So there is a question to be asked about institutions - particularly those institutions which have grown so large and unwieldy, bureaucratic and sometimes dangerous so as to make them vulnerable to this kind of environmental disaster.

The institutionalisation of health is something that has happened the world over. Some thinkers, notably Ivan Illich, were always critical of the institutionalisation of public services, which has gone hand-in-hand with "professionalisation" which disempowered individuals to do things for themselves. It basically revolved around the principle of declaring "scarcity" around issues of health, treatment and technology where professionals were invested with the authority to exclusively make pronouncements around aspects of life where individuals were often perfectly capable of organising themselves to deal with if they had access to the technologies and drugs themselves.

This is particularly true in the light of our information technologies. Criticism of the use of technology for self-diagnosis and treatment is based on legitimate concerns about the results of technology. But the problems with technology are not the fault of technology. They are the fault of institutions of health defending their own structures and greedy tech corporations making profits in the shadows of large medical institutions. Health institutions chose to denigrate "Dr Google" and assert the status of institutional judgement rather that consider how health might be more effectively organised with technology in ways different from institutional hierarchy.

It is the same in education. Online education has been available since the beginning of the web. The story since the web has been one of the institutions defending themselves against technology, commandeering technology to defend their structures and practices. There was never any attempt to reform a viable institution of education online. Had there been, Facebook would have been a very different thing.

The point is that an institution is a kind of technology and coronavirus will break them. We may protect the technology of our health institutions, but in the process we will break the technology of our other institutions. Our institutions are not organised effectively. Their supersized structure is not an effective form of organisation. Unfortunately, the reaction to the current crisis is causing a ramping-up of the scale of health institutions. This is understandable: now is the time to react as best we can. But our institutions were vulnerable because of the way they are organised and the scale on which they operate.

The declarations of scarcity over technologies, treatments, and care are not effective ways of organising health in society. The pandemic genie is out of the bottle. We know that this will happen again, and next time it could be worse. So while we must now react, we will need to think about what "effective organisation" in health and education really means in the future.

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