Examination of Witness (Questions 480
- 499)
TUESDAY 16 JANUARY 2001
DR ANNE
COCKCROFT
480. Right; so exposure, simply exposure could
go a long way to eliminating it?
(Dr Cockcroft) It could help.
481. Tell me, in countries which are short of
cash, how do they pay these bribes, do they pay them in cash,
or do they borrow to pay in cash, or do they pay in kind, do they
do it overtly, or do they use the famous brown envelope technique;
how do they do this?
(Dr Cockcroft) In lots of ways. People know the language
of this sort of thing, so that if you go along and perhaps you
ask for a service, the man might say to you, "Come back tomorrow
and bring your brother," and if you come back with your brother
he says, "No, no, no, come back and bring your brother,"
which means you come back and you pay a bribe; or "I need
a stone to hold down the papers." So there are all sorts
of ways of asking for this. And we heard of sort of complicated
arrangements, sometimes they say, "You go to a certain bar
and you pay some money to the barman," and then later, of
course, the person that is taking the bribe later goes and takes
the money. So you may not pay directly to the person. And very
often you might pay to a broker, a middleman, that is quite common
in health services and other services, so that you pay that person,
who then pays the health worker. So there are lots of ways it
happens. It may not be a money transaction, it could be a chicken,
for certain services you pay a chicken, or you pay two chickens.
So, yes, it is not only money, there are lots of ways these transactions
happen.
482. How do you know what to pay, how much to
pay, how many chickens, or perhaps just chicken pies?
(Dr Cockcroft) Because you live in the place and the
currency is quite clear. In Bangladesh recently, in focus groups
we were asking people and they say, "Well, if you pay nothing
then you see the doctor, after a long wait, and he sees you for
maybe a minute; if you pay 20 taka, you can see him still in the
government facility and he will see you in the afternoon but he
will see you for longer; if you pay 50 taka then you will see
him separately." So there is a—
483. So, a tariff?
(Dr Cockcroft) Oh, yes, and quite often people know
what the tariffs are. However, having said that, one of the difficulties
for people is that there is an uncertainty about it, they do not
know, necessarily; in that circumstance they know, but if you
are in hospital, say, you do not know what you are going to be
asked for, when. We have stories about people, the drug round
is taking place in the middle of the night, the last drug round
of the day, and suddenly the people coming round with the drugs
say, "Well, unless you pay us this amount now, that's it,
you don't get the drugs." So those sorts of things happen.
So there is a lot of unexpectedness about it, people do not know
how much they are supposed to pay, or how often, how many people
will ask them to pay.
Chairman: Terrifying.
Mr Worthington
484. I am just wondering about how this spreads
and just becomes endemic, and the kind of situation where you
might not have any money changing hands but where certain people
are seen as a threat, because they are wealthy, to the lowly police
officer, or health official, and so on, so that, do you get signs
that, in fact, you do not get the investigation of crime, where
it is known that the people are powerful; can you take us through
that?
(Dr Cockcroft) Yes, I think that can happen as well,
that, for example, you have situations, well, you might be arrested
for a crime you have not committed. We all know the thing about
being stopped by the traffic police, and being in the traffic
police is quite a good way to make money, because you stop people,
and then you pay them to not take you to court; of course, you
might have done a real offence and then you can pay for that not
to be taken forward. So, yes, certainly, the perception is that
if you are rich and powerful you can buy your way out of anything.
485. Yes; that is a further stage of the corruption,
is it not, where the person does not arrest or does not investigate
those who would be a threat to themselves because they could go
in higher in the chain?
(Dr Cockcroft) Yes; or that they may actually be making
a direct payment in order to get off.
Chairman
486. Does the tariff vary according to who you
are, is it lower for women than men, or is it higher for people
who earn more, or if you are a Chinese in Malaysia do you have
to pay more than a Malay, that sort of thing?
(Dr Cockcroft) It is interesting; the recent survey
we have just been undertaking in Bangladesh, in health services,
we looked at that issue, and we were looking at unofficial payments
that people made when they had contact with the health services,
and what we found was that poor people, people who had a household
income below a very poor line, they reported paying less in these
additional payments than the less poor people, and women also
reported paying less. I am not entirely sure how that works, but
there does seem to be some way in which perhaps there is some
relationship to what you can pay. Having said that, poor people
were less likely to be prescribed medicines, and they were certainly
less likely to be satisfied with the way they were treated; so
you begin to form an impression that those who are paying less
are getting less of a service.
487. Now what happens to the delivery and quality
of services if petty corruption is left unchecked; they just go
downhill, do they?
(Dr Cockcroft) I guess, certainly in some of the places
where we work, you might think that is already the situation;
effectively, there is not a service, people do not use it. In
Tanzania, for example, this was back in 1995, it was noted that
in quite a lot of communities people did not use the police at
all, because of the problems that they perceived with corruption
in the police. And what has happened is that vigilantes have grown
up, which are sort of groups of local people that take the law
into their own hands, and that may be alright, you know, well,
this is community action, and so on; on the other hand, they are
quite fierce, if they catch somebody for stealing, or whatever,
they might beat them to death. So there are difficulties of that.
So, yes, effectively, you get a situation where people, when you
go to a village to discuss the service, they will laugh in your
face, they will say, "Well, what service? We don't have access
to that service, it's a private business, there is no government
health service." So, effectively, that is what you end up
with.
488. Yes; that is what you end up with, you
end up with lawlessness, in fact. So it is very serious, is it
not?
(Dr Cockcroft) Yes. It means that the people who most
need the services cannot get them.
Ms Kingham
489. I have just been looking down the list
of countries that you work in, and they are all very developing
world-based, obviously, from the nature of the work you are doing,
but you are working with community organisations, as you put it,
to enable people to find their own solutions. Now, presumably,
you are coming from some kind of point of view about what appropriate
solutions are; so what models are you basing those on, where are
you getting this information from? And do you actually look at
corruption in European countries, too, because, obviously, a lot
of the donors and the NGOs that you are working with will be European-based,
and we are by no means, in Europe, free of corruption ourselves.
I have been reading up recently about some of the Tangentopoli
corruption scandals in Italy, and some of the activities that
have been going on in Britain. So how can you be sure that you
are not coming at it through a Euro-centric viewpoint, and where
are you getting your models of this good development from?
(Dr Cockcroft) The first thing to say is that, just
sort of to clarify the people that we work with and whose views
we seek, it is not so much, if you like, representatives of civil
society, or civil society groups, and so on, it is actual people.
We go house to house, so that in communities we would survey every
household in those communities, which are selected to be representative
of areas of the country, and so on, and then we would have focus
group discussions, with ordinary community members, not with civil
society groups. Civil society groups are fine, and many of them
are very good and do very good work, but you cannot necessarily
assume that they will be representative of the whole community,
they do not necessarily represent the views of the most disadvantaged
groups. So, in terms of what do we come with, in terms of what
we think are solutions, I would not say that we do, what we are
looking for is to get the views of the people on the ground in
that country, and in that part of the country, about what solutions
might work for them.
490. So do you never come up with recommendations,
or do you never come up with a suggested programme? Because somebody
will be interpreting that data, that is got from those households,
so why do you feel that what you are doing is in any way more
representative, even though you are discussing those people, you
are still filtering the information, than the civil society groups?
(Dr Cockcroft) What we tend to do is take the findings
from the household survey and we take those back to be discussed
with focus groups, with service providers, so that we get their
interpretation of the data; so that recommendations do come, yes,
but primarily they are recommendations that arise from what the
people are telling us.
491. And that is done on a majority basis, is
it, of how many people would agree an outcome?
(Dr Cockcroft) For focus groups, that is difficult
to say, because, obviously, you are taking fairly small groups.
But what we can do, on the basis of the numbers, if you like,
is that you can look at, okay, this number of people did this
thing, and you can relate it to different risk factors, if you
like, and you can look at corruption. If you look at it as a disease,
let us say, you can use epidemiological techniques to say, in
people who are in this situation, they were more or less likely
to pay a bribe compared with others in another situation. So,
for example, we were able to say that people who had been given
helpful information about how to use the service were less likely
to have paid a bribe than people who had not been given that sort
of information. Therefore, we can say, and you obviously have
to take into account all the other factors that may affect it,
but, having taken those into account, you are then able to say,
on the basis of the data, not your interpretation, you are able
to say, if everybody were to be given helpful information about
how to use the service, this is the difference in the rate of
bribes that could be achieved, taking into account the other factors
that also affect the rate of bribes. So there are two things.
First, there is use of epidemiological techniques, and it has
to be epidemiologically and methodologically robust, otherwise,
of course, people are going to say, "Well, you know, it's
just your own view;" so, first, it is based on the data.
And, second, then there is the qualitative view, from the people
in that place, "Well, what might work here?".
492. How do you evaluate and monitor your recommendations,
do you go back and do an audit, are you audited by anybody to
ensure that what you are doing is accurate?
(Dr Cockcroft) That is the intention; the intention
is always that this should not be a one-off process, that you
should have a survey and discussion groups, and so on, and then
that should lead to some potential interventions, that may help;
but, of course, it is crucially important to go back to see, well,
what interventions were actually done and did they make a difference.
493. And you always do that, as a matter of
course, do you?
(Dr Cockcroft) We want to do that; it is not necessarily
within our control. Because, obviously, we tend to be contracted
to do this work by different groups, it may be funded by different
international groups, like UNICEF, UNDP, World Bank, and so on,
and perhaps the actual contract may be with the Government, so
they may or may not wish us to go back; it is much better if they
do because then we are able to follow up to see what happened
and what difference did it make.
Mr Colman
494. I want to ask you about the difference
between the delivery and quality of services, those that are centrally
government-run, as opposed to those that are locally government-run,
and, in a sense, police and judiciary tend to be more centrally
government-run. Are you finding, as local government seems to
be taking root in many developing countries, with locally-elected,
accountable politicians, that is helping, in terms of removing
this sort of level of petty corruption from a number of areas
of local government-run public services, or is there such an endemic
level of corruption that the individuals who are locally being
elected are almost having two tariffs, one for those who vote
for them and one for those who do not?
(Dr Cockcroft) I think that decentralisation certainly
offers opportunities for improving local accountability, local
transparency, because at a local level it is small enough that
somebody actually can go and thump on the desk of the chap and
say, "Well, what happened to this money?" and you can
publish in the local papers, "This is the amount of money
that's gone to the schools for books," and so if the books
do not turn up you can be in a position to say, "Where are
the books?". So I think that decentralisation of services
does offer an opportunity for more local control. Having said
it offers an opportunity, it does not mean it is necessarily going
to be an opportunity that is taken; and it could be, and I think
sometimes it does happen, that you simply add another layer of
bureaucracy, another opportunity for corrupt practices.
495. These are not corrupt, these are locally-elected
politicians?
(Dr Cockcroft) I know, but vote-buying is still a
common practice, prior to elections it is a very common practice,
that people go around and they will give you, whatever it might
be, "if you vote for me". So I do not think you can
say that because a politician is locally elected that means necessarily
that they are going to be locally accountable.
496. So there is no differentiation, you feel,
in terms of countries where there is a vibrant local government
and countries where there is not, in terms of the level of corruption
in the delivery of local public services?
(Dr Cockcroft) I am not sure that I would say that.
I think that, in countries where there is more decentralised power
in that way and people are locally elected, I do not know if it
has actually come to fruition yet, necessarily, but I think the
opportunity is there for more accountability locally, and I think
that local politicians are more likely to take the results of
the sorts of survey that we are doing here and act on them, they
are more interested to do something about it, because they—
497. Have you got any examples of success, in
terms of doing this?
(Dr Cockcroft) No, not as yet.
Mr Rowe
498. We had a somewhat dispiriting session with
some of the UK's largest companies, in which very senior managers
explained that, where the local culture made it inevitable, although
they would not approve of it, it was normal to pay hurry-up money,
and so on and so forth. And, I just wondered, you have hinted
once or twice that some people are entirely open about the fact
that they or their colleagues will take money for various purposes,
how open, in your experience, is it that this level of a small
amount of corruption is kind of publicly acknowledged by the people
who actually benefit, take the money, from it?
(Dr Cockcroft) It is interesting. We have been having
some discussions in a number of countries about just this thing,
as I mentioned, taking back the findings of these surveys both
to the service users, or intended service users, and to the service
providers. And it is quite an interesting experience, when you
confront service providers with the information from their district,
not from somewhere else but from their district, last month, so,
"This is contemporaneous data and this is the number of people
who had paid extra payments, let us say, to health service workers,"
and you usually do that towards the end of the discussion, having
talked about other issues, about service provision. And at that
point people sort of shuffle around, and there is a bit of sort
of, "Oh, well, uh, uh," but people do tend to say, "Well,
perhaps people have misunderstood what it was, it wasn't really
a bribe," or they will say, "Well, yes, some people
do do that, we're trying to tackle it; it has happened but it's
very rare." Service providers, in that sort of public forum,
will admit it, when confronted with the evidence.
499. But they will not say, for example, "What
do you expect, with wages as low as this?"
(Dr Cockcroft) Some will, yes, some will, some will
say, "Yes, it happens and it's very difficult to prevent
it, because of wages," and so on. When you talk to people
individually they will tell you that people who go to, let us
say, a doctor, who goes to work at a local level, does not start
off intending to take money from the patients, they reckon it
takes about six months. And it is sort of a slow process, first
of all the wife might say, "Well, we haven't got a very good
house," and then, "People are looking at us, why aren't
you making money so that we have a good wage, you have the right
to do that the same as everyone else?". So there is a huge
incentive towards doing it, that somehow you are able to look
after your family, you are a big man if you are doing it, and
you are a fool if you are not doing it; so there is this sort
of pervasive attitude about it, that most people crack after about
six months, they reckon. So I think it is very easy to blame the
individual people concerned, but I think you have to look at it
in the context.
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