history, states, societies, and citizenship have been shaped by the way
states have provided protection to their citizens against war. As
citizens, we made a fundamental bargain: We empowered the state and
charged it with the responsibility of providing protection from attack and
collective destruction, and in return, we gave the state our loyalty and
deference. In the past two months, as we have done many times before, we
are turning back to the state to provide security from attack.
are we again in the familiar relationship where we, as citizens, empower
the state to provide security from attack and in return give it our
unquestioning loyalty and deference? I suspect not.
unlikely that we will reinforce our traditional bargain with the state
because, in the past few decades, we have begun to change the way we live
our citizenship. We are part way through a long process of constructing a
different picture of ourselves as citizens, and a different kind of
relationship with the state. In this past year, I visited public schools,
community clinics and hospitals to listen to the voice of citizens. I was
not chiefly interested in health care and education, although they are
very important to us as citizens, but rather in how we experience
citizenship, not as an abstract idea, but in how we give it meaning, day
in and day out. How do we live our citizenship in post-industrial society?
I first began to listen, I heard talk of efficiency or cost-effectiveness
everywhere in our discussion about public goods. Not only did I hear it, I
lived it. My mother was hospitalized last year after she shattered her
hip. Seven days after her surgery, a discharge co-ordinator caught me in
the hospital corridor and asked what arrangements we had been able to
make. I told her that my sister and I would need more time to find
suitable accommodation where my mother would not have to climb stairs. The
co-ordinator replied: "Your mother is now a negative statistic for
this unit. Every additional day that she remains in hospital, she drives
our efficiency ratings down."
as I raged about the conversion of a whole person to a negative number, I
understood: Responding to a growing insistence on efficiency, her unit had
been given seven days to discharge a geriatric patient after a fractured
hip. If the patient remains on the floor for 10 days, the surgical unit
becomes less efficient than the hospital and the government expect. In
post-industrial society, efficiency has become an end, a value in its own
right. Efficiency grows out of the competition that markets bring but what
we are efficient at is discussed less and less, and sometimes not at all.
When efficiency becomes an end instead of a means, it becomes a cult.
course, it is important to use efficient -- or cost-effective -- means to
provide valued public goods so that public funds, which are never infinite
and almost never adequate, can stretch to meet as effectively as possible
the largest number of public needs. What distinguishes legitimate
conversation from the ritual incantations of a cult is a serious
discussion of purpose. But it's a complicated conversation: As soon as we
begin to talk about purpose, our judgments are inevitably laced with
example, to determine whether our schools are efficient at providing
public education, whether they are cost effective, we have to understand
the purposes of education. Effective at what? At producing literate
students? At producing critical thinkers? At producing engaged young
citizens? Would we want a system of public education where the majority of
our high school students know nothing of Canadian history or values but
excel at science and mathematics? What, in short, are the goals of
education or health care in Canada? Without a discussion about the goals,
and the values that inform these goals, we cannot even begin to talk about
efficiency. Once we begin to talk about goals, it quickly becomes clear
that efficiency is not politically neutral.
the past 20 years, critics of the "inefficient" state have
suggested new market-driven ways of providing public goods to citizens.
These new experiments, including vouchers for public education and charter
schools, medical savings accounts and public markets for health care,
don't deliver what they promise. They have not yet provided clear gains in
efficiency. But they are intensifying the demand for greater
accountability in the delivery of our public goods.
citizens, we badly want accountability from our public institutions.
Whether we are talking about student achievement or medical error or
patient satisfaction, we feel we have the right to know how public
institutions are performing, whether they are effective. This is the voice
of the citizen in post-industrial society.
citizens change, so does the role of the state. It becomes contractor,
regulator and partner. The state as contractor and regulator now has no
choice when it enters into contracts but to specify, in advance and with
some precision, exactly what kinds of services are expected and what kinds
of standards must be met. Governments must now collect information not
only about the costs of delivering public goods but also about their
quality. The tragic results in Walkerton, Ont., and at airports in North
America provide eloquent warning of the consequences of focusing largely
on costs and failing to monitor quality and performance.
the state was the sole deliverer of public goods, it had every incentive
as a monopolist to conceal rather than reveal. The new post-industrial
state needs transparency among providers, assurances of quality, and
evaluations of the effectiveness of the public goods that are delivered.
So do citizens.
as the state contracts out responsibilities for the delivery of public
goods, many of our traditional institutions -- legislatures, committees --
lose their capacity to monitor, investigate and steer programs. The
citizen becomes more important than ever.
standards for those who deliver our public goods is difficult. The
fundamental issues come alive in how we choose to count the dimensions of
a problem. Yet, if we cannot devise standards for our local public school
or the hospital down the street, how can we begin to think seriously about
holding our more distant and impersonal governments accountable? And, if
we cannot hold our public institutions accountable, how do we give meaning
to our experience as citizens?
critical question for citizens then becomes: Who sets the standards for
our public institutions? Is accountability imposed by the state or
negotiated through open, democratic processes? And, do we have the
capacity to negotiate accountability? Much of the democratic debate of the
next decade will turn on whether accountability is imposed or negotiated.
It is the new battleground in the construction of democratic society.
[Professor Janice Gross Stein is the Director of the Munk Centre for International Studies at the University of Toronto, the Harrowston Professor of Conflict Management, and a Fellow of the Royal Society of Canada. This article was first published in the Globe and Mail, Toronto, Canada. Adapted from The Massey Lectures 2001 --The Cult of Efficiency, published by House of Anansi Press; series to be broadcast on CBC Radio's Ideas. ]