Despite all the posturing on this serious issue, London Mayor Sadiq Khan is failing badly on knife crime, writes Cllr Robert Ward, Vice Chair of Scrutiny.
There’s a dreary monotony to the response after each tragic loss of another young life to knife crime. TV talking heads express sympathy, brush quickly past solutions (a nod to “public health approach” and “Glasgow”), assert it is NOT about the police (“you can’t arrest your way to a solution”), then run out time to-ing and fro-ing on the numbers of what it is supposedly not about.
Politicians are not much better. Ask what public health approach means in practice and you won’t get much beyond “treat violence like a disease”. That sounds comforting, especially to those who prefer to absolve perpetrators of responsibility. Treating violence as you would treat the spread of a disease does not mean it is a disease. You don’t catch violence. Solutions offered tend to be unstructured pleas for more of all the services that touch upon young people, cue blaming ‘austerity’ if it is an opposition politician.
The truth is that there is no simple solution. Root causes are complex and of long standing. The public health approach, or model, which was developed by the World Health Organisation (“WHO”) is well suited to just such a situation.
The approach reaches right back into the history of public health and the physician John Snow, who in 1854 identified the source of a cholera outbreak as a public water pump by studying the pattern of how the disease was spreading. Snow did not understand the mechanism, germ theory was yet to be developed, but by gathering and evaluating data and trying out solutions he solved the problem.
The public health approach has even been shown to work in combatting violence. It was applied in Chicago, brought to Glasgow and later extended to the whole of Scotland. Ten years after adopting its initial 10-year plan, there have been good results there.
The approach is a four-step process: define and measure the problem; identify risk factors; formulate and test ways of dealing with those factors; and implement what works on a larger scale and stop doing what doesn’t. Reliable data is critical to success. According to the WHO World report on violence and health from 2002“Reliable data on violence are important, not only for planning and monitoring purposes, but also for advocacy. Without information, there is little pressure on anyone to acknowledge or respond to the problem”.
This is a critical stumbling block. The relevant data is typically spread in the UK across many databases maintained by different agencies, so hard to access quickly in a coherent way. Without good data you are fooling yourself. You certainly aren’t following the Public Health Approach. The Youth Violence Commission report from 2018 warned that the term ‘public health model’ is being used without a proper understanding of what is required to effect lasting change.
This is not the only risk. The Glasgow model was a Violence Reduction Unit set up by the Police. In the early years there was a focus on custodial sentences, DNA processes and finger printing all knife carriers. This moved on to a review of remand guidelines and changing sentencing recommendations on knife crime. Enforcement created the space to give longer term preventative approaches a chance.
In contrast, in London the Mayor has set up a Violence Reduction Unit (“VRU”) and in Croydon we now have a Violence Reduction Network. Both are led by former Labour councillors, indeed the Croydon network is currently little more than that. Their adherence to the Public Health Approach is weak. The Mayor’s VRU has made a perfunctory effort at step one of the approach, but the projects aiming to address the issues, whilst well meaning, show little attempt at quantitative evidence gathering to enable a judgement on their effectiveness. Auditable, objective success measures are almost entirely absent.
Worse still, flexibility and objectivity are made more important because the threat constantly changes. What worked yesterday may not work today. The evolution of drug distribution from crack houses to street delivery changed the landscape. Control of the streets, irrelevant beforehand, became important, leading to opposing gangs fighting over turf. Street distribution needs deliverers, which sucked in younger and younger children. In recent times, victims of stabbing have become less likely to report the incident or even attend hospital because they know this will identify them.
If we are not informed by a systematic use of current evidence and choose projects without verifiable success measures we will spend a lot of money ineffectively and not deal with the problem as quickly and effectively as we might. We will be left with traditional multi-agency working delivering a
scattergun of projects selected based on old information, who gave the best sales pitch, pet projects, and political favouritism.
That is the Public Health Approach in name only. It is a more expensive way of doing what we already were. It is a betrayal of our young people and a waste of taxpayers’ money. Another reason, if one were needed, to remove Mayor Khan in May. We might want to sharpen up our own act too.