My theoretical deliberations didn’t play out in an institutional vacuum. In 1997 I was appointed a Reader at UCL, and in 2001 a Professor. True to form for one of Margaret Archer’s meta-reflexives, I had rarely shown myself to be proactive in my own interests. My idea of ‘getting on’ was, and remains, largely confined to developing ideas and advancing theories. I was even inclined to act as judge and jury in relation to my own papers and publications, not being unduly swayed by others’ reactions (I’m not proud of this). I also had a very Anglo-Saxon suspicion of ambition and conspicuously ambitious people. I remember once saying to Stan Newman, ‘you’re ambitious, aren’t you?’ His very reasonable response was ‘what’s wrong with that?’ I had to admit that my question was loaded and, if anything, betrayed my own parsimony. It was in fact only when I saw others of my peers being promoted around me that I judged I had better put myself forward.
Becoming a professor certainly satisfied one ambition. I had never wanted to retire as a senior lecturer. I’m not sure why I felt this way because I was aware that many excellent academics in the past, and indeed more recently, had ended their careers without becoming Professors. Titles, as all academics should be willing to confess, do not always reflect talent or even accomplishment. I suspect my perspective was coloured by what might be called an inflationary spiral of promotions in higher and further education since the 1960s. When I attended Surrey University in 1968, Asher Tropp was the only Professor of Sociology. As was customary then, it was a title largely confined to Heads of Departments. Exceptions were relatively rare: Margot Jefferys at Bedford College supported George Brown’s promotion from Reader to a Personal Chair for example. Since then we have seen both a proliferation of universities and allied institutions and a greater tendency for titular rewards within them. In short, I was introduced to the university sector at a time Chairs were scarce and was awarded one myself when they were plentiful. I am not implying that there is anything wrong with this, merely that I had travelled through and experienced a significant institutionalised shift. Professors are now everywhere. I recall being invited to act as a referee for a candidate for a Chair at a new and little-known university. I was compelled to recognised both that she met the institution’s criteria for such a promotion and that she would not meet UCL’s criteria for a Lectureship. I had better qualify these comments further.
As I say, I was more discombobulated than disturbed. I have lived through a transition from a degree of uniformity or standardisation in what a degree amounted to and what a title meant to one in which what mattered most – after the fashion of the American system – was where you obtained either or both. My reference points had changed. The more important point perhaps is that top-rate sociologists can be found throughout this novel, elongated hierarchical system, in sociology as in other disciplines. More than this, there are good sociologists outside the universities and kindred bases. Moreover, there are now also a significant number of good sociologists who cannot get a foothold in settings that offer liveable salaries and security: many of these are being lost to the discipline. But I am jumping ahead again.
Typically, the award of a Chair brings with it an opportunity to give an inaugural lecture. I received and accepted such an offer and delivered the lecture in 2002. The title I devised was ‘The Jigsaw Model: Towards a Composite Picture of Health in Society’. What I called the ‘jigsaw model’, briefly, had three aspects. First was a ‘best guess’ at an overall picture of the dynamic, complex and highly differentiated social world we inhabit. The second was a series of models, articulated in terms of logics, relations and figurations, each constituting a discrete piece of the jigsaw. And the third was a process of dialectical reasoning by means of which the sense of the overall picture informs the application of models, and the application of models informs the sense of the overall picture. An additional comment on the salience of logics, relations and figurations is in order. Consider the following example: the logic of the economy can be seen as the regime of capital accumulation. This logic establishes the parameters for real (in Bhaskar’s sense) relations of class. Such relations, when exercised, become generative mechanisms and manifest themselves in tendencies, albeit in open systems. The logic of capital accumulation and relations of class can be examined within a number of different figurations. My sociology of health inequalities within the figuration of the British nation-state can still be framed in terms of the jigsaw model, though I have in fact ceased to do so. The central theme running through my lecture was the increasing health inequalities in the context of figuration of the British nation state. I drew on two sets of logics and relations. The first, as mentioned, was the logic of the regime of capital accumulation and relations of class; and the second was the logic of state regulation and its associated relations of command. My argument can be anticipated from my earlier account: it was that in financialised or rentier capitalism relations of class have expanded their influence over those of command, with the result that they exert increasing control over the formation and implementation of social and health policy, with deleterious consequences for poorer member of society. I went so far as to sum this process up by referring to the GBH.
The lecture was introduced by Mike Spyer, formerly Dean at the Royal Free and subsequently Dean within the UCL Medical School, after which Stan Newman said a few complementary words. I’ve no idea what Mike Spyer, a physiologist, made of my lecture, nor would I wish to speculate! I enjoyed it, although it’s always problematic trying to assess how these things go. Annette and my daughters – Nikki, Sasha, Rebecca and Miranda – were there, as were a group of Epsom friends with whom I had played badminton every Monday evening for nearly three decades (not all of whom shared or share my political convictions). A number of my peers and colleagues were also present, for which I was enormously appreciative. More alarmingly, sitting next to James Nazroo, was George Brown. Maybe fortunately, I had no chance to discuss the lecture with George, but I cannot think he found it within his comfort zone. I did, however, have a quick exchange with Mike Wadsworth, then also based at UCL. Mike said he had enjoyed the talk and asked me if he could attend the next one. I must have looked confused, so he added: ‘well obviously you’ll be sacked by UCL after this one.’ Inaugural lectures are strange experiences, a kind of trial by fire. We adjourned to the nearby Senior Common Room and bar.
It was in 2006 that I was to experience a trauma of a very different genus. It came out of the blue. I was chatting to our Centre secretary, Liz Wake, outside Stan Newman’s office; and she let it drop that the Head of the Department of Medicine in which our Centre nestled wanted to see me. I was curious as to why and not a little alarmed. Why was Patrick Vallance about to summon me into his presence? As I was querying the purpose, Stan appeared and overheard our conversation. ‘We had better have a word’, he said. Seated in his office, there occurred an explanation that left me both bewildered and unsettled. Stan explained that three member of our Centre – James Thompson, Roland Littlewood and me – had been identified as surplus to requirements. Discussions had taken place around possible transfers to other departments within UCL, including Michael Marmot’s Department of Epidemiology, but with no success. Stan commiserated, said he knew that I particularly liked teaching, and mentioned that he had contacts with Thames Valley University and could if I wished contact them on my behalf. The fact that Thames Valley was at the time ranked bottom of all British universities only added to my confusion.
I left Stan’s office stunned and disorientated. A short while after I found myself seated in front of Patrick Vallance, future Chief Scientific Officer, with Stan in attendance. The former went through my CV, which was clearly beyond his ken, and asked if there was a senior colleague to which he could submit a few chosen publications for their feedback. I suggested Nicky Britten, whom I respected and felt was broadly sympathetic with my work (apparently the result, when Nicky’s comments eventually arrived, was positive). Patrick also helpfully suggested that I attract a ‘small grant’ as Principal Investigator, say for £1m, and think about getting a paper in the journal Nature. He was clearly clueless as to how sociology differed from his own field of laboratory medicine. I nodded obligingly and as requested made comprehensive notes on what we had apparently ‘agreed’ and was expected of me in consequence.
There were several sequelae to this meeting. The first was that the threat of imminent redundancy seemed to have receded, even if temporarily: there had been no mention of it, but rather a generalised warning about my future measurably productivity. I felt obliged to respond to the demands made on me in some meaningful way as a matter of self-protection. The second was the onset of a stressful period of continuing uncertainly: what did Patrick Vallance’s pointed pep talk with its implicit warning add up to? Was it an appraisal that was setting me up to fall short? Third, I immediately adjusted my output of publications, switching from a longstanding predilection for writing books to concentrating on articles in peer review journals (I had passed off my book on sport to Patrick by insisting that I did it in my spare time: some people relaxed by playing golf, I explained, but I relaxed by writing on sport). In the event I upped my rate of publishing markedly after this meeting, finding it easier and quicker by far to write short articles than long books. Fourth, I began to make enquires with a view to transferring to another part of UCL. I did this on my own initiative and without sharing my intentions or the results with either Stan or Patrick. What I found was that the options for moving into another UCL faculty or department were indeed available. One Dean asked me about my teaching and, on discovering that I did ten lectures to 360 medical students, let slip that this alone was worth £100,000 in paper money, so in this respect at least I was a desirable asset. The possibility of establishing a Unit in Medical Sociology was mooted, but Paul Higgs decided that his position was more secure staying put, so that option died a death. In the end I moved into Graham Hart’s Department of Infection and Population Health in Mortimer Market, the other side of Tottenham Court Road, but I’ll come to that. A fourth consequence of this unsettling episode was a souring of my relationship with Stan Newman. It seemed to me that he had exaggerated the threat to my position at UCL, and this interpretation seemed to be confirmed by my conversations with other Deans and Heads of Department throughout UCL as well as within UCL Medical School: I was obviously not a persona non grata. Had it suited Stan to appease/please Patrick Vallance by making savings? Some years on my anger has subsided and I now like to think that the unexpected and awkward initial conversation with Stan had caught him unawares and led him to improvise and unwittingly to convey a misleading impression.
I had a long exploratory conversation with Graham Hart prior to moving into an office in Mortimer Market. I had known him as an excellent medical sociologist for some years, and I had also been on his selection committees twice, first time when he was appointed to a lectureship at the Middlesex, and then again when he was appointed as Professor to run the Department of Infection and Population Health. I stressed to Graham that I needed and wanted to retain my independence and not to find myself under pressure to tick too many institutional boxes. My assumption was that if I transferred to his department, he would stand to gain a post – to reoccupy as he wished – on my retirement (in seven years or so). I found our conversation reassuring. After all, I was reasonably productive in my own non-metric fashion, and I had had some impact on our subdiscipline over the years.
It proved a good move. Graham was to remain welcoming and supportive and my productivity did at least not falter. Moreover, my newfound proclivity to publish more articles, without neglecting books and chapters, stood me in reasonable stead. I published seven papers in peer review journals in 2006 and went on to place a further 20 before retiring in 2013. These figures are of course unimpressive when compared with those accomplished by contemporary sociologists, but for me they represented something of a surge. To lend perspective to this, I also published four edited books between 2006 and 2013, plus 24 chapters. My new office provided the kind of private space that I had always seen as essential given my preference for solitary working and my meta-reflexive inclinations. Graham Hart’s office was just down the corridor and I was fortunate to be close to a number of enthusiastic and friendly researchers of varying degrees of seniority. I found it interesting that I was to mix and get on more easily with this group than I ever had with most colleagues in psychiatry.
So 2006 was a turning point. My record was no longer subject to the ruminations of a clueless laboratory-based academic and the threat to my employment had been lifted, I presumed permanently rather than temporarily. At the same time my perambulations around UCL in search of job security had taught me a good deal about UCL politics and the Machiavellian machinations of some Heads of Department and Deans. I had added to my stock of experiential knowledge to compliment that acquired through professional sociology. Before too long this was to prove useful.