A guide to crapitecture

Two years ago on a cold November day, I visited the Nottingham Contemporary - a new centre for the arts resembling a square black box, built on the side of a hill next to the splendid High Pavement area of the City. When we had eventually found the entrance, we discovered that there were no exhibitions at all that day, although the staff did tell us that we were free to use the (over-priced) café and buy things in the large museum shop.

Nottingham Contemporary is a archetype of what should be called ‘crapitecture’, which can be recognised from these guidelines:

1.    It is difficult to find the entrance. Before the rise of crapitecture, all builders and architects strove to make the entrance as imposing as possible. This was achieved through porticos, archways, and gatehouses. Even humble dwellings had a front door, plainly visible, often painted in bright colours to indicate the pride of the inhabitant. But crapitects see their work as a personal statement of their artistic merit - a kind of very large sculpture, and there is no front door on a sculpture.

2.    It fails in the most basic sense to meet the requirements of its occupiers. Like the Nottingham Contemporary (an art gallery without any art), crapitectural buildings fail in the most basic way to fulfill their function. Roofs leak (it helps if they are flat), vast interior atriums waste most of the internal space of the building and are expensive to heat, libraries are over-heated and noisy, and so on. Of course, the lack of exhibits is not the fault of the architects who built the Nottingham Contemporary, but there is an increasing tendency for museum buildings to attract more attention and cost more than the items they supposedly exist to display.

3.    It is located with no reference to the surrounding townscape, except in the negative sense of destroying a previously attractive local view or dominating all nearby buildings. All of us have a favourite list of such crapitectural buildings. Like most British cities, much of Nottingham has been defaced by grotesque developments - the Broadmarsh Centre which blocks off a medieval street, or the utterly vile Maid Marian Way. Nottingham Contemporary does not quite deface one of the best remaining areas of townscape in the City, but it hardly adds to it. Did the architects even visit the site?

4.    It is widely praised in the architectural press. The website for the Nottingham Contemporary includes a long list of quotations extolling its virtues. Fortunately, there are rival voices in architecture, such as the annual Carbuncle Awards (website below).


All this might suggest that the people of Nottingham have neglectfully allowed their city to be defaced without protest. I suspect that is not the case, and, that like most people in this country, they are dispirited at what has been done to their beloved city, town or village. Bad architecture exists because people have limited power over what is built in their community. In the past, the aristocrats, merchants and bishops who had the power and resources to erect great buildings often had an eye for beauty, and so competed to build the most beautiful buildings. More importantly, they also erected buildings that they would themselves live, work or worship in. Monumental buildings now are often the product of corporations working with international design consultancies, and are built with an eye to the next customer in Dubai, Shanghai, and such places. Once built, they become a temporary entry in a marketing portfolio. The rest of us have to put with them for far longer.

Carbuncle awards

First days at work

We all remember our first day at work - the uncertainty, curiosity and fear. But some first days are a lot worse than others. In 1986 my contract with the Medical Research Council was due to come to an end, and I accepted an invitation to apply for a new post of Director of Planning and Information at what was then the Mental Health Unit of Central Birmingham Health Authority. Since I was the only candidate for the post, the job was mine. The Unit had been under the temporary management of a psychiatrist (Dr Patsy Goodyear) until the first of the new NHS general managers could take post. My appointment was intended to promote the very innovative ideas for mental health services developed by Dr Goodyear, and her colleague Dr Michael Radford. We were later joined by a superb psychogeriatrician Dr Hilary Nissenbaum.

On my first day, I arrived at the John Connolly Hospital. This was a rather battered building, dating from the 1960s,, which had originally developed a reputation as a rather non-conformist therapeutic community. By 1986, it had become a more standard inpatient unit, admitting patients from designated city wards in Birmingham, divided into ‘adult’ and ‘elderly’. Nevertheless, the Hospital was in a pleasant open space, patients could come and go easily, and patients and nurses would kick a ball around in front of the hospital at lunchtimes.

After arriving at reception, I was met by an efficient personnel officer and shown to my ‘office’. This was actually a partly-enclosed space in a corridor next to the toilets. There was a very old desk and chair, and a broken telephone. I gathered that my arrival was not welcomed by all the senior staff in the Unit. There was no induction training, or any indication of what I should do, so I wandered round making appointments to see whoever I could. Later that day, a cheery bricklayer arrived and began to wall me in to create a room. In the next few days, better office equipment arrived, I met the Unit General Manager, and began to be useful.

Over the four years I was in the post, the Unit planned and opened a phenomenal range of innovative services: inter-disciplinary mental health resource centres, the first team in the UK to treat people with acute and severe mental disorders in their own home, an intermediate treatment unit in an old people’s home, and community psychiatric nursing teams that recruited from all languages in the City, while we also planned (with Professor Ian Brockington) a new specialist academic psychiatric inpatient unit at the Queen Elizabeth site. We were therefore in process of developing something quite different from the model of psychiatric services which had been government policy from the mid 1970s. I also helped develop a low-cost computer system which generated rather better data than the expensive Patient Administration System (PAS) promoted by the computer companies and their satraps in different parts of NHS management.

Unfortunately, the satraps won. Central Birmingham Health Authority was merged with its equivalent in South Birmingham, and the combined mental health unit fell under the control of managers and senior nurses who had learnt their trade in big old-fashioned psychiatric hospitals. They were suspicious of academic clinical units, and naturally committed themselves to PAS. The new inpatient psychiatric unit opened in 1991, but became over-crowded. It was demolished 15 years later to make room for a new general hospital, and its replacement is a typically-plush product of a PFI deal. But as you pass it on the railway line, you can see the tiny exercise spaces and the high fences round the inpatient wards. This is to some degree the consequence of the very reforms we promoted. As more and more patients with acute mental illness were treated at home, only the most dangerous and disturbed were still admitted to inpatient care. Psychiatric hospitals became progressively more restrictive.   

Our dynamic staff team was also demolished. People retired or moved to new posts. The general management team fell into disarray, and the general manager developed an interest in setting up his own private nursing home. One day, without warning, his office had been cleared and he was never seen at the hospital again. I left in 1990, and, to my great surprise, became an academic. However, I still look back on my four years in the NHS as the time in my working life when I was most useful.

A Midsummer Nightmare

No poet has been more cruelly treated after his death than Shakespeare. In his lifetime, not one person doubted that he was the author of his plays or poems. But doubt has now become common - usually argued on the snobby grounds that a glover’s son without a university education could never be a great poet. But Shakespeare went to a good grammar school in which an intensive programme of teaching involved a thorough knowledge of the classics. And, like many other people, before and since, he also educated himself - a feat perfectly possible without being attended to by a university teacher. In any case, Shakespeare’s rampant originality of voice combined with a ruthless plagiarism of stories from elsewhere would have made him a most unwelcome student. Like Robert Burns, Shakespeare was the vigorous voice of popular poetry, deeply aware of human nature, and a shrewd observer of its triumphs and failures.

Even greater acts of cruelty to Shakespeare are carried out by those directors who see his plays as a means to celebrate their own fame rather than the words of the poet. I suffered this on my wedding anniversary on September 23rd, when my wife and I went to the Royal Shakespeare Company’s production of a Midsummer Night’s Dream in Stratford-on-Avon. The stage was set out, for no particular reason, as a seedy nightclub. Chairs hung from the ceiling, and were raised and lowered at different points in the play. This meant that we were unable to imagine a wood outside Athens - which we could have done if there had been just a bare stage.

But there was worse than that. The play was done for laughs: plenty of frantic slapstick, devoid of any sense of drama or the wonder of a magic. Helena’s anguish from unrequited love - something we have all experienced - was lost in comic over-acting. The wonderful moment in Act IV when Demetrios, Lysander, Hermia and Helena wake to find their night of magic is over was lost to drama. Finally, the cast pretended they were not in a play written by Shakespeare. They ignored the verse spoken by the Athenians in the play (the English workingmen who Shakespeare inserts in the play use everyday speech). So we lose the force of Puck’s last great speech to the audience, which speaks for Shakespeare himself:

    If we shadows have offended,
    Think but this, and all is mended,
    That you have but slumber’d here
    While these visions did appear.
    And this weak and idle theme,
    No more yielding but a dream,
    Gentles, do not reprehend:
    if you pardon, we will mend:
    And, as I am an honest Puck,
    If we have unearned luck
    Now to 'scape the serpent's tongue,
    We will make amends ere long;
    Else the Puck a liar call;
    So, good night unto you all.
    Give me your hands, if we be friends,
    And Robin shall restore amends.

Denying disability

In August this year, the High Court in London awarded £6.6 million pounds to Leo Whiten, a seven-year-old boy who had suffered brain damage as a result of medical negligence at the time of his birth. Leo now has cerebral palsy, limited mobility, cannot stand or walk unaided, and has no functional speech. His mother noted that: “He will never be able to live independently, will not be capable of any form of employment and will never have the necessary mental capacity to be able to manage his own affairs.”

Awards of this kind are usually divided between annual payments and a lump sum. The annual payments are to meet the additional costs required to live with a disability and the resulting loss of earnings, while the lump sum (in this case £2.7 million) is to meet costs already incurred and to compensate for the distress caused by the injury. Estimates of additional costs take into account life expectancy and the level of social care required, which in Leo’s case is needed for 24-hour/day. The additional healthcare costs that might be needed by Leo are of course met by the NHS, and Leo will also be eligible for statutory disability benefits, which are currently £73.60/week for the care component and £51.40/week for the mobility component at the highest rates.

Very few people who are disabled from birth receive compensation payments to cover their loss of earnings and their need for social care. Instead, they depend on services provided by local authorities. Funding for these has increasingly been devolved to individual disabled people, ostensibly to increase their personal control over the services they receive. But these ‘individual budgets’ are not an entitlement like the disability benefits - they are paid purely at the discretion of local authorities. As central government grants have been reduced, local authorities have responded by tightening eligibility criteria for social care and reducing levels of payments. Public funds have as a result met an ever-smaller proportion of the true costs of social care and amount to very much less for people with severe disabilities than the sums paid to Leo Whiten.

Leo, like other people with severe disabilities, will not pay personally for using healthcare or for attending school, which means that these costs fall on the public purse. However, many people with severe disabilities from birth require more intensive healthcare interventions than the rest of the population, including the use of expensive specialist services. Special education for people with severe disabilities is also more expensive than that provided in ordinary primary and high schools. This all means that the lifetime cost of severe disability (both for the public purse and for families) amounts to several million pounds per person.

Faced by these circumstances, both families and governments are tempted to resort to miracle cures, and there are many persuasive charlatans able to supply them. Some families have spent large sums of money sending their child to Florida in the belief that swimming with a particular set of dolphins can ameliorate Autism. Others have paid to be trained in a technique which involves constant manipulation of a child’s arms and legs, all of which is supposed to train his or her brain to overcome Cerebral Palsy. Since this level of intervention can not be sustained, parents come to blame themselves for their child’s continued disability.

For governments, charlatanry takes a different form: there is a sustained denial of the impact of severe disability, coupled with a pollyannaish belief that people with severe disabilities from birth can, with a bit of help, attend ordinary schools (and hence avoid the cost of special education), find an ordinary job in the open labour market (and hence be ineligible for social security), and use ordinary (and cheaper) non-specialist health services. Policies of this kind have a particular power because they can be presented as liberating, and can be contrasted with the sad history of the stigmatisation and de facto imprisonment of people with severe disabilities. But this is the radicalism of fools. It means that disabled people are less likely to get the services the need, and more likely to be incarcerated. The Department of Health has run down its inpatient care for people with intellectual disability who have mental and/or behavioural disorders. This has been promoted and legitimised by its now-defunct Valuing People Support Team. But mental disorders and behavioural disorders have not been magicked away, and there has been a compensating expansion in residential and inpatient care by the private sector. This can take the form of ‘downwards substitution’, in which people who need skilled nursing care get cheaper residential care, provided by untrained and over-stretched staff. The Winterbourne View case (exposed by television rather than the formal ‘quality assurance’ bodies) shows the results.

Of course, some people have benefited from these changes. They include the former head of the Valuing People Support Team, who has now moved to a senior position in the main private company providing residential care in England.

The Rudeness of Strangers

I spent much of the early part of my life being unnecessarily rude to others. Gradually, I learnt more social skills, and acquired a liking for easy conviviality rather than blunt assertion. But there have been times when I have been accused of  rudeness without just cause. Here are three examples:

The first was at the University of Birmingham, when I had an appointment in one of its academic buildings which had been converted from a large house. The oaken front door was solid, heavy, without any window, and stiff. I pushed with no result. After a second, firmer push, the door sprung open and hit a woman standing just behind the door who was in conversation with two other people. I apologised to the woman. “How rude”, she said to me, angrily.

The second was in a street near Covent Garden in London. Four elegant young women were walking very slowly side-by-side with linked arms, completely blocking the pavement. I was in a rush to catch a tube, and politely asked “Excuse me”. “How rude”, one of them said.  The third case was at a cash machine in Worcester. A young woman was on the mobile phone while entering the codes to check the balance of her account and to withdraw funds. In between each digit she entered, there would be a protracted conversation on the phone. Distracted by the conversation, she entered digits incorrectly and had to re-insert the card several times. After five minutes of this, I asked politely if the rest of us in the queue could have a go at the machine. Not speaking to me but instead to her mobile phone, she said “There’s a man here who’s been really rude to me”, with indignation.

The last two cases are similar. They involve people who behave selfishly, and who then express indignation that they must pay attention to the needs and wishes of others. This is perhaps the true character of everyday egoism. Egoists do not deliberately seek to crush or ignore others - they instead see others as having no identities at all, or at the very least having only minimal identities compared with the shining light of their own person. When the needs of others unexpectedly intrude, they experience a sense that their own world has been invaded and react with some anger. This can even lead to minor insults or setbacks from others becoming the basis for a lifelong antagonism. Like Miss Havisham, clad forever in her wedding dress, the original insult becomes an immovable part of their life and character.

Beyond everyday egoism, there is the more pathological variety. The previously-successful Shropshire businessman who became bankrupt and then suicidally depressed, reacted by killing his entire family and his pet dogs, and then burning all his possessions. In his eyes, his family, his house and his expensive cars were merely extensions of his own ego, and therefore logically had to be destroyed alongside himself. In other cases, the pathological egoist will decide that he or she has a special mission, which may involve wiping out opponents or bringing some religious truth to the unenlightened. These two missions have often been combined, making governments with religious leaders some of the cruellest in history.

What about the first example of an undeserved accusation of rudeness - the woman hit by the stiff door? All sorts of psychological speculation are possible, but it may just have been ordinary human stupidity.   

Is higher education a rip-off?

Students in most English universities will next year pay £9000/year for their three-year degree course. Is this £27,000 value for money? One way of determining this (popular with governments) is to promote higher education as a personal investment, with a financial return to the student in the form of increased future earnings. However, there is little reliable data on which to base such a calculation. Information about earnings after university comes from data collected before the current recession and at a time when a much smaller proportion of school-leavers attained a degree. The investment model is in any case of dubious value because higher education should be much more than just a means to the end of accumulating ever more possessions.

A more appropriate way of assessing value for money is to calculate how much a good  university education should cost to deliver, and whether this corresponds to what students will be charged in fees. Anybody who has worked in a university will suspect that they operate at less than optimal efficiency. Expensive lecture theatres and teaching laboratories are used for 26 or so weeks/year. There is an expectation in many universities that all academic staff will do research as well as teaching, thereby avoiding the gains that accrue through specialisation. Courses may take years to set up, and universities commonly offer many degree programmes with small numbers of students.

So let’s imagine a university that operates more efficiently but still delivers a high quality of education. In the first place, it will aim to make better use of its capital and human resources by teaching three 15-week semesters/year, instead of the usual two. To calculate how much this will cost, we can simplify things by omitting STEM (science , technology, engineering and medicine) courses because they incur high equipment costs for which universities are compensated by a central government grant. How much teaching should students receive? Over the last few years, universities have reduced teaching hours and increased the number of students in small group teaching (some have 20 or so per ‘small group’). There is also a trend to offload undergraduate teaching to postgraduate students. These trends have their apologists, who say that the quality of the teaching is more important than contact hours. But this is rather like parents who pursue their own careers rather than spend time with their children, and then rationalise this by saying the hour or so they do spend is ‘quality time’.

My imaginary university will do none of those things: all students will receive 20 hours face-to-face lectures/week, plus one hour/week of small group tutorials in groups of ten students, all led by academic staff. How many academic man-hours would this involve? I estimate that each one-hour lecture needs four hours to prepare, but only one hour to revise for the next time it is given, and that each lecture needs a thorough revision once every five years. This gives a mean of 1.6 man-hours of preparation for each hour of lecturing. Small groups require less preparatory work - about one hour for a new tutorial and half an hour to revise. This gives a mean of 0.6 man-hours preparation for each set of tutorials. My imaginary university operates on the Melbourne model, with a small number of large degree programmes - let’s say each has an annual intake of 100 students. The 15th week of each semester will be allocated for exams. No course work will be marked (except as a formative assessment) because of the large and growing problem of agencies which write essays, dissertations and even theses for a fee. Student examinations will each take one hour to mark for each semester, requiring 300 hours for the programme each year.

Based on this data, we can calculate the academic man-hours to deliver each programme as 3156/year. If we assume that each academic works 30h/week on teaching (including preparation time) for 45 weeks/year, this indicates a requirement for 2.3 academics for each year’s intake of 100 students. This would mean a teaching team of 4.6 academic staff for the course as a whole. Let’s assume that the mean staff costs/academic are £50,000/year, resulting in £116,888 cost/year. Academic staff costs are about 36% of total university costs, which would produce a cost of £324,689/100 students, equivalent to fees of £3,247/year and £6,494 for the full degree course.

It would be possible to reduce these fees even lower if some efficiencies could be attained in university administration, which has expanded in recent years because of the spread of quality assurance paperwork and the increasing complexity of the admission process. Universities also have a tendency to build expensive monumental buildings, sports centres, art galleries, conference centres, performance venues and so on. My imaginary university would concentrate on academic matters rather than entertainment (which is available in plenty in the areas in which most students live). Finally, many universities subsidise research from teaching income. The strategy here has been to enhance the prestige of the university (and of course its senior academics), thereby attracting students who wish to attend a prestigious university however limited its commitment to teaching. In my imaginary university, the emphasis would be on scholarship rather than the more circumscribed activity of research. Research would take place, but in defined research centres, which would be expected to be financially self-supporting.

These figures are of course speculative. It could be argued that there should be a balance more in favour of small group teaching rather than lectures, or that some non-STEM courses incur higher costs such as those in the arts (which require specialised equipment and incur high material costs). People who propose such arguments are welcome to make their own revised calculations. A further criticism is that academic staff would be unwilling to spend so much time on teaching. This is probably true of many academics at present, but the solution lies in recruiting people who enjoy teaching for its own sake, combined with a strong desire to keep abreast of current knowledge in their field.

Is this imaginary university ever likely to happen? I would prefer it to be a co-operative, run by its staff on John Lewis lines. But it is rather more likely that private organisations will spot the commercial advantages, charge rather more than £6,494/course but a lot less than the market rate of £27,000. Perhaps then students in the more expensive universities will realise how much they are being ripped off.

Working with ethical complexity

All work involves (or ought to involve) some ethical complexity, although this occurs less in some jobs than others. An ethically simple job would be the sale of lawful and non-harmful goods. The salesman is employed to sell, and receives payment to do so. The ethical requirement, therefore, is to meet the terms of his contract with his employer, which usually involves the aim of maximising sales. However, a conflicting ethical demand could arise if the salesman suspects that a customer does not need or cannot afford the product he has persuaded him to buy. The salesman may resolve this dilemma by telling himself that the customer is exercising free choice. This is more convincing if the salesman has taken the trouble to explain the full costs and features of the product. This is now often required by law, as a means of protecting consumers who would otherwise be ‘mis-sold’ products.

At the opposite end of the ethical complexity scale are occupations such as medicine, which require the frequent resolution by individual practitioners of multiple and often conflicting ethical demands. This has generated the academic discipline of medical ethics, to investigate these conflicts and propose rules for their resolution. But similar degrees of ethical complexity can occur in much poorer-paid and less well-trained occupations. For instance, support workers in residential care for people with cognitive impairments face ethical dilemmas on a daily basis. Do they allow their clients to take the kind of risks acceptable for almost all people, or do they protect them from potential harm? In more practical terms, do they allow a client who has no sense of direction and no awareness of the danger of motor vehicles to walk out into the street alone, or do they let them out only if they are accompanied by a member of staff or other responsible person? Should the staff allow a client to eat what they want, even if this results in gross obesity, or do they restrict their access to food? Do they allow a client to repeatedly hit their head against a wall, or do they restrain their limbs and insist they wear a protective helmet?

Faced by these dilemmas, support staff (and the public at large) usually favour exercising a ‘duty of care’, to protect those with severe cognitive impairments from exploitation and harm. Duties of care are most commonly experienced in the way in which we deal with children and people who are ill. It is not surprising, therefore, that some staff talk of their clients as if they are children rather than adults, or sick people rather than disabled and healthy. This is not sign of incompetence or malevolence, but a way of dealing with the real psychological stress involved between treating such a person severe cognitive impairments as an autonomous adult (as specified in numerous policy statements), while at the same time carrying out tasks that emphasise constantly their very lack of autonomy.