The South left its mark on the IOCU’s increasingly ambitious programme. Its 1978 Charter put poverty relief and the environment at the heart of consumer protection. The right to consume was balanced by the social and ecological responsibilities that came with it. Such appeals were not without their crusaders in the rich North. Ralph Nader, who shot to fame in the United States in the late 1960s with his exposures of exploding cars and corporate abuse, campaigned for a shift from conspicuous to conscientious consumption. The UN’s Guidelines on Consumer Protection (1985) were proof consumers had arrived in the corridors of international politics. Kennedy’s principles had grown into an international bill of consumer rights, including an emphasis on just, equitable and sustainable development. From Finland to Brazil, the guidelines became the point of reference for new consumer laws.95
Yet the guidelines’ birth was far from simple and foreshadowed troubles to come. Having led the battle for consumer protection at home, the United States dragged its feet internationally. American companies protested against interference in their foreign markets. When the UN General Assembly voted for an international list of unsafe, banned products, the United States provided the one vote of dissent. The American delegation fought the 1985 guidelines tooth and nail and, while it was unable to stop them, made sure that its provisions fell short of those at home.
Back in Washington, consumer protection and ‘Nader’s Raiders’ had set off a corporate backlash against regulation. The post-war settlement, symbolized by Kennedy’s bill, had balanced individual choice with a better life for all. The Reagan administration tore it up. What was left was choice. Deregulation looked to business to keep its house in order. The Federal Trade Commission was told by Congress to suspend its investigation of children’s television adverts and similar subjects. The Consumer Product Safety Commission survived efforts to abolish it by the skin of its teeth but now focused more on voluntary standards.
Internationally, all eyes turned to opening up trade. The very moment the consumer movement reached the corridors of global politics, the action moved behind closed doors as the Uruguay Round of trade talks got under way in 1986. It took a decade for the talks to be completed and for the World Trade Organization to be set up, in 1995. In low- and middle-income countries tariffs fell from around 39 per cent in the early 1980s to 13 per cent by 2000.96 Consumers might be the beneficiaries of the freer movement of goods, but they were certainly not invited to the negotiating table. Worse, free trade put those who saw it as the consumers’ best friend at loggerheads with many activists in the South who felt it ran roughshod over social justice and local development.
The momentum for choice was top-down, sponsored by the architects of the neo-liberal ‘Washington Consensus’. Equally interesting was a second, bottom-up dynamic. This was not spearheaded by lawyers, economists and businessmen, nor was it about waving the magic wand of the market in foreign lands. It came from ordinary people who demanded to be heard as users of public services. Today, the welfare state is often mocked as the ‘nanny state’, from which Thatcher and Reagan liberated downtrodden citizens. Yet it was not all bossy and stubborn. Public services contributed their own laboratory for choice. At first, some choice was granted at the discretion of officials and providers. Eventually, recipients began to assert their rights for themselves.
A major arena was public housing. In Britain, the first support for choice came from above as slum clearance got seriously under way in the 1930s. Who was to decide what colour curtain graced a new block of flats: government or tenant? The housing director in Leeds was R. A. H. Levitt, a trained architect who, inspired by the Karl Marx Hof in Vienna, brought high-rise living to England with the eight-storey Quarry Hill flats. He brushed aside those who clamoured for uniformity. The ‘taste of the tenant is not always good’, he agreed, and they might need advice, but it ‘would be a retrograde step to rob the tenants of that little expression of individuality’. Control in public housing was necessary, ‘but it should be limited . . . after all, we in this country still pride ourselves in being democratic’.97 After the war, and notwithstanding austerity and fuel shortages, authorities in Manchester let tenants choose whether they wanted a gas or an electric cooker when they moved into a new council home. Yet choice had its limits: future tenants were stuck with that first decision for good.98
By the end of the 1950s, such gestures were no longer good enough. Tenants began to complain that their local authorities were high-handed, unresponsive and negligent. An earlier generation had been grateful to be rescued from private slum landlords. As slum conditions ceased to be the norm, tenants became more demanding. The mood swing resulted from two forces coming together, one material, the other cultural. Tight budgets and poor planning forced cities such as Manchester to build flats on the quick. Labour had promised the New Jerusalem. When tenants opened the door to their new home they often found damp and mould instead. On the Beswick estate in Manchester, windows came crashing down to earth because the fastenings were not strong enough.
Equally significant were the rising expectations that came with rising incomes. The home – its comfort, possessions and the social life they made possible – was their manifestation. In the 1950s, spending on household goods doubled. By the early 1960s, many tenants gained the right to move partition walls as they liked. An official report for the Ministry of Housing recognized the need for greater accountability as well as choice. Tenants expected fair treatment and to have the right to complain.99 It left the thorny issue of redress unanswered. After all, council tenants, unlike private ones, did not have the option to move house if they were dissatisfied. For Conservatives, this distinction remained axiomatic. ‘In a free country,’ the 1963 Conservative housing policy stressed, ‘the householder must be prepared to meet the cost of his house where he is able to do so. Otherwise he will have little freedom of choice.’100 This was unlikely to appease council tenants asked to pay rising rents while waiting for repairs. As the decade progressed, some took councils to court. Others joined protest marches and tenant associations. Poor people might be dependent on the state. Nonetheless, one association said, they should have the ‘indisputable right’ to take decisions that concerned their everyday lives, their homes and their community.101 In her dual plan in 1979 for a ‘right to buy’ and a Tenants’ Charter for those who chose not to, Thatcher capitalized on that earlier wave of anger. She did not create it.102
The movement for patient rights was the second major arena in which users were asserting greater voice vis-à-vis professional experts and authorities. Although healthcare was provided by a mix of public, private and charitable bodies, the issues of choice and voice were similar to those in the public sector. By the early 1970s, the ‘health consumer’ had entered the political lexicon. As with tenants, patients’ metamorphosis into consumers did not begin with neo-classical economics but with a critique of authority and a revival of voluntarism. Patient groups signalled a new confidence in self-help. The origins of this reach back to the 1930s with Alcoholics Anonymous in the United States and increasing interest in homeopathic medicine. The real burst came in the decades after the Second World War – in Britain, these years saw the birth of MIND, the National Spastics Society, the Muscular Dystrophy Group, the Patients’ Association and a host of other mutual support groups.103
There was one major difference between patients’ groups and tenants’ associations. Unlike in housing, where there was never enough funding to fix all the holes, healthcare saw more doctors and pills than ever before. Voluntarism was a reaction to what critics called the ‘medical-industrial complex’ and its monopoly on expensive, by-prescription-only medication. Doctors were challenged for being over-specialized, distant and too reliant on pharmaceutical handouts. They needed to stop playing God and listen to their patients. In addition to older calls for safe medication, American and British activists demanded greater privacy, legal protections for those suffering from mental illness and a stop to hospital trials without
consent; that such experiments continued notwithstanding laws following Nazi atrocities was especially galling. Cure, they insisted, ought to be more patient-led. These demands came to the fore the very moment the consumer movement was targeting unaccountable business and government more generally. Nader’s first branch of his consumer advocacy group Public Citizen was the Health Research Group. The American Civil Liberties Union started to defend the rights of the ‘medical consumer’. The voice of the patient chimed with that of the citizen-consumer.
Like the proverbial genie, once the health consumer was out of the bottle, it was difficult to control. At first, it looked as if patients’ activists had struck a victory. England and Wales established Community Health Councils in 1973. These were intended as a consumer watchdog to help patients with everything from complaints and more flexible visiting hours to better hospital food. In reality, most councils did not dare to bark. As the 1970s progressed, the health consumer was hijacked by the state and business.
In Britain, where the state ran a National Health Service, the government’s interest in self care was fiscal as much as medical: healthier citizens and active volunteers were a cure for unhealthy public finances. ‘Everyone knows that there is going to be less money,’ Dr David Owen, the then Labour health minister and a trained neurologist, pointed out in 1976. People had to learn that ‘health is not just something that is provided for by the NHS, but that each individual has a responsibility for his own well-being.’ Volunteers needed to get involved in looking after the sick, the elderly and, he added, ‘psychiatric patients who have been discharged’.104 A year earlier, Owen had given a government grant to the Patients’ Association. The principles of self-help and voluntarism were first co-opted, and then managed by the state. The return to power of the Conservatives in 1979 accelerated this process. The more the Thatcher and Major governments celebrated choice, however, the more choices were made on behalf of rather than by patients. Ironically, reforms ended up delivering new powers for doctors and managers. For campaigners, choice had originally been a capacious ideal, accommodating collective concerns about equality of access alongside demands for individualized treatment. Some even proposed that consumers as taxpayers be brought into overseeing health providers – after all, it was they who paid for the NHS. By the time the Tories launched their Patient’s Charter in 1991, the health consumer had shrunk to an individual customer in a ‘quasi-market’.105
A similar deflation of choice happened in the United States, only more swiftly, in the absence of a comprehensive public health service. Consumer and patient groups – never the most coherent coalitions at the best of times – were outflanked by the medical and pharmaceutical lobby. By the 1990s, half of Americans’ health insurance was financed through government taxes.106 Struggling to check the spiralling cost of Medicare, government pushed doctors to be more competitive and encouraged private HMOs (Health Maintenance Organizations) to drive down costs. Patient empowerment became a commercial venture. Consumers had wanted more information and choice. Now they were swamped with them, as long as they were able to pay. For those without medical coverage, choice was irrelevant. Even in Scandinavia, choice pressed its way into welfare services. In 2003, Denmark gave the elderly a choice between private and public care. The freedom to choose, the Finance Ministry waxed philosophically, articulated a democratic view of human nature: citizens, not the system, knew what was best for them.107
Tenants and patients fought for warm homes and better treatment, but they also signalled a general shift in political atmosphere in Western democracies in the post-war years. Public services were under pressure to put their users first instead of treating them as deserving objects of charity. The reorientation towards users put to the test the most fundamental relationship between state and citizen, that between governors and governed. What was government for if not the people? Who protected citizens against wrongdoing at the hands of the state? The answer came from Sweden: the Ombudsman.
The office of Ombudsman had been created in 1809 to keep an eye on state officials and ensure laws were executed as the king intended. A strong state was checked by the rule of law. It was in the twentieth century that the Ombudsman switched from a guardian of royal interests into a tribune of the people. His main business was to protect their civil rights against an overarching state. Appointed by parliament, he had the power to inquire about judges. In the 1950s, thousands of Swedes filed grievances about court actions, administrative malpractices and heavy-handed police. Internationally, it was the one Swedish word on everyone’s lips. Denmark introduced its first Ombudsman in 1955. New Zealand got one seven years later. From there, the office reached the United Kingdom in 1967. Ombudsmen arrived in Spain and Portugal in the 1980s, after the fall of dictatorship, and in Poland and Hungary, after the collapse of communism. At the time of writing, Britain has twenty-four Ombudsmen, whose remits range from police complaints and helping consumers who were missold insurance policies to adjudicating football complaints.108
Why did the Ombudsman’s global career take off when it did? One reason was the particular social democratic constellation of the period. Ombudsmen helped societies to reconcile a fast-growing state with a commitment to markets and democracy. This is the standard explanation. A second, perhaps equally important reason has to do with the changing habits of citizens. If everyone took malpractice on their chin, there would be nothing for the Ombudsman to do.
There are indications that greater affluence has encouraged complaining, in part because of rising expectations, in part because the channels encouraging us to complain and the ease of doing so have increased exponentially. Some of this reflects the expansion of customer service in businesses, although standards continue to diverge hugely. Yet states deserve credit, too. In a bustling marketplace, it is easy for a dissatisfied shopper to move their custom elsewhere. If there is only one water company in town, this is impossible. State-sponsored consumer complaints boards and the promotion of ‘alternative dispute resolution’ have given ‘voice’ a new outlet. Where collective redress mechanisms exist, consumers make use of them – Spain and Portugal are good examples. In countries where action requires a mandate by each individual victim (as in France) or out-of-court settlements are difficult (as in the Netherlands), consumers don’t. The Portuguese Association for Consumer Protection is part of an especially successful model of class action; when it brought a case against Portugal Telecom on behalf of the country’s consumers, it won a settlement of damages worth €120 million. Similarly, in Spain, where collective redress mechanisms are in place, consumers tend to use them, as when the Association of Bank Users (ADICAE) filed a lawsuit against 101 banks on behalf of 20,000 claimants about illegal mortgage clauses.109
Technology has facilitated ‘voice’, too. Consumers who feel defeated by their electricity bill are now just one click away from venting their frustration. Whether they do depends in part on whether they trust that their complaint will be handled fairly. And this varies enormously between societies. Institutions and cultures of complaint reinforce each other. It is probably no coincidence that the greatest complainers live in those countries that have the strongest tradition of Ombudsmen, complaint procedures and trust in the rule of law. One in three Swedes made a formal complaint in 2008, and every fourth Dane, Briton and German. In Italy, it was not even one in ten.110 Some have turned complaining to creative use. In Helsinki in 2005, a group of Finns pioneered a complaints choir (Valituskuoro), grumbling that ‘we always lose to Sweden in hockey and Eurovision . . . ’ Since, similar choirs have formed in St Petersburg, Melbourne, Singapore and two dozen other cities; in Hamburg, the singers’ complaint is directed at the overly complicated German tax form. The Budapest choir claims that Hungarians are the world champions of complaining.111 Even in England, home of the stiff upper lip, a first choir has started in Birmingham.112
The Ombudsman was an example of the lively flow of ideas and institutions between countries. Such transnational exchanges had
long been a part of consumer movements, reaching back to the buyers’ leagues in 1900 and to the anti-slavery boycotts a century earlier. The European Union added a new, supranational dimension. It took a surprisingly long time for European bureaucrats to fall in love with the consumer. The ‘consumer’ was barely on anyone’s lips in Brussels in the 1960s. It was only from the mid-1970s that the European Court of Justice began to harmonize national measures on safety and quality, and only in 1987 that the Single European Act included a ‘high level’ of consumer protection.113 There were good reasons for the late awakening. Ever since the French Revolution of 1789, the spirit of law was about upholding universal civic rights. There would be no special protection. Granting special rights to consumers would have violated the autonomy of contracts between equals. Lawyers and economists alike fell back on the convenient fiction that the consumer was naturally ‘sovereign’ in the marketplace. The 1970s broke the silence. As the engine of political integration hit the buffers, European officials and judges switched tracks to economic integration. The consumer would be the locomotive; choice and competition the fuel. A new European citizen was born: the ‘market citizen’. After centuries, German beer makers were told in 1987 that their beer was no healthier than Belgian lager and to remove their restrictive purity laws. It was for consumers to choose which beer they wanted, and any national hurdles that stood in their path had to be cleared away. Choice would empower consumers – this was the official justification. It also empowered the European Commission.
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