The Hartheim Statistic and the strategy of indecent delay

Or what democracies have learnt from the Nazis about saving money on the care of disabled people.

In June 1945 an American officer investigating activities at the Hartheim death camp in Upper Austria broke open a strong box containing a 39 page document. That document included a monthly breakdown of the activities of the 6 death camps involved in the National Socialist government’s so-called “Euthanasia programme” Aktion T-4. Part of the breakdown was an estimation of what the National Socialist government had saved itself in murdering over 70,000 disabled people. This figure of 885,000,000 Reichsmark came to be known as the “Hartheim Statistic”. And just to give an idea of the amounts that we are talking about. In 1942 at an exchange rate of 10 Reichsmark to the pound this would equate to approximately £88,500,000 which is approximately £4,277,319,084 in today’s (2021) values.

It shouldn’t surprise anybody that civil servants and politicians attempt to attribute an economic value or cost to their actions and choices, however there are few governments in the world that would emulate the actions of the Nazis and their decision to save themselves money by actively murdering disabled people, including children. But the reality was that even the Nazis had problems getting the public to accept what it was doing to disabled people. By 1942 the official Euthanasia Programme – Aktion T4 – had to come to a close. This was largely as a result of the actions of the Catholic Bishop Clemens von Galen who had spoken out against the killings in his sermons as well as groups of incredibly brave German citizens. Whilst the bishop’s high profile protected him from being incarcerated in a concentration camp or killed, most Germans who spoke out against the National Socialists, such as the Scholl siblings, would eventually pay for their resistance to National Socialism with their lives. But in this instance, together they were successful in stopping Aktion-T4.

It was one of the few times during the Third Reich that public protest was able to change government policy. However, despite a public end to the “Euthanasia” programme, the Nazis continued to murder disabled people in secret until the end of the war. They had learnt that if the state wanted to save money on the “care” of disabled people it had to do it quietly, so the Euthanasia programme went quiet. This was often done through a combination of active and passive means, such as drugs, deliberate infection and the withdrawal of food and the living conditions needed to sustain life.  

Whilst the active eugenics of the Nazi’s is clearly condemned across all civilised societies, the idea that disabled people represent an unreasonable financial burden on society is an idea that has persisted. And the strategy that the Nazis employed toward the end of the war – that of failing to provide people with the means to live healthily – as an effective means of shortening their lives – is a lesson that has not been lost on non-authoritarian forms of government.

Before I take this argument any further, I should just like to point out that it’s not always helpful to make direct comparisons between the actions of non-authoritarian democratically elected politicians and the National Socialists of Nazi Germany. National Socialism, its leaders, its supporters, and those who simply accepted it were ultimately responsible for an unimaginable number of deaths, for genocide, for systemic torture and untold human rights abuses. When viewed as a whole, even at their worst, no modern democratically elected government comes anywhere near the injustices and barbarity of National Socialism and Fascism.

But the “success” and effectiveness of National Socialism never really came from its coherence and integrity, it came from its ability to incorporate popular sentiment and resentments into sets of ideas and beliefs that people would see as common sense and reasonable. These sets of ideas emphasised the importance of national identity and nationalism, the need for a strong and powerful state, control of the media and disinformation and the stigmatisation of minorities and groups who were deemed to be a threat to the national majority. And it did this with a level of state violence that most of us would find difficult to imagine.

It is sometimes useful (although not always) to distinguish between the ideas and values of National Socialism as an ideology and the incarnation of those ideas in Nazi Germany. Because whilst Nazism may have been violently expelled to the political margins by the sacrifices and struggle of millions, over recent years it is becoming increasingly clear that many of the ideas and beliefs of National Socialism are being reworked and reincorporated into our everyday politics and culture. Sanitised for a new electorate but more insidious and in some ways a greater threat to the values that underpin democracy than a battalion of brown shirted thugs.

So, for example we see that “populism” – the practice of incorporating popular sentiment and resentment into policy – has re-emerged as the pre-eminent strategy in our politics. In the UK, our problems are all now the fault of the EU and of immigrants, in Poland it is the judiciary and in Orban’s Hungary you can add the LGBT community to the list of the resented and stigmatised. But the re-emergence of far right thinking and its incorporation into mainstream politics extends beyond the stigmatisation of minorities, the circumscription of rights and the creation of faux enemies, and it is often done in a way that makes it difficult to distinguish from the politics of reason and decency.  Nowhere is that more evident than in the support that democracies offer to older and disabled people.

For modern democracies the cost of providing support to older and disabled people represents a significant proportion of any government’s spending and the opportunities for savings offered by not having to provide support should not be underestimated. Governments of all persuasions are aware of this. They know that delaying policy and action saves money, and they also know that delaying policy and action can cost lives and it is this moment that distinguishes normal politics from the reworked National Socialism of the New Right. Not acting to save money is a reasonable and defensible policy choice, not acting when you know that your inaction will cost lives is something far more sinister. Because for the New Right, the state’s role in protecting the well-being of older and disabled people should be minimal, regardless of the human cost.

In many respects the situation is at its worst for people with learning disabilities. In the UK for over twenty years, we have known that people with learning disabilities are dying far younger than their peers and for over twenty years governments have postponed and delayed acting meaningfully on this knowledge. Because they know that fixing the problem would involve massive investment in the way in which people with learning disabilities are able to live their lives and a revolutionary transformation of the way in which the healthcare system operates.  

At some point in those twenty years the delay in acting on the premature deaths of people with learning disabilities went from a reasonable and perhaps understandable delay in developing policy to something indecent, something deliberate, something that weighed the lives of people with learning disabilities against the cost of preventing their premature deaths and decided that they weren’t worth it.

But these life and death choices go beyond the lives of people with learning disabilities. The failure of successive Conservative governments to develop a coherent and funded plan for social care, and their repeated failure to develop other high-cost policies relating to the health, care, support and needs of disabled and other vulnerable people is not accidental – it is strategy – a strategy of indecent delay.

Up until recently, it hasn’t always been a strategy of the government, but very much one of the far right of the Tory party which has known that blocking action minimises the role of the state and saves money.  And if it costs the lives of older and disabled people then that is a price that they have been willing to pay, or at least let others pay. Now inaction has become the go to response to any of the challenges that this government faces – delay and save money irrespective of the consequences.   

It seems clear to me that this government’s strategy of indecent delay and the ease with which it will balance lives against cost – in particular as it relates to disabled people – draws on a key element of National Socialist thinking. Namely that disabled people are a financial burden on the state and society and that steps should be taken to minimise that burden. Whilst in the aftermath of the Euthanasia Programme the Nazis were able to reduce the cost to the state behind the closed doors of their camps, the strategy of the New Right is far simpler – you do nothing because doing nothing leads to premature deaths and that saves money. And then when people realise what is going on – you do next to nothing, write a report, and carry on.

The statisticians of Hartheim would have been proud.     

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Threads of time

If you drive north from Vienna through the rolling plains of Lower Austria toward the Czech border, after about an hour you get to the town of Mistelbach. It’s over 40 years now since I’ve been there, but I always remember the golden fields of wheat and barley that we passed on the way. It was long before Austria joined the European Union and a good while before the Iron Curtain fell. It’s hard to imagine it now – Europe divided by barbed wire fences and machine gun posts but I remember them. We were on our way to my girl-friend’s parent’s house in the country. It wasn’t in Mistelbach itself but a small village nearby. I can’t remember the name, but I do remember the house and I remember that he was building it himself.

Her father, who we’ll call Herr Schmidt, was a master joiner who seemed to work all the hours of the day and a few more. He’d get up at four in the morning to go to the market to buy fruit and vegetables for the small convenience store that he and Frau Schmidt ran in Vienna’s 6^th Bezirk. When he’d done that, he’d go and do his main job as a joiner until early evening when he would return to the shop to do the evening shift. When he’d finished, he’d go home and have his dinner and by 9pm he’d be in bed. At the weekend – which was probably just Saturday afternoon and Sunday – they would all leave for their home in the countryside where he would continue working on the house.  

By the time that I got to see it, it was almost finished. It stood in its own small orchard of apricot trees, had a pool and at least three, if not four large bedrooms and two kitchens. One in the cellar for the summer when things got too hot. I remember being impressed and I loved the pool and the orchard and the underground kitchen. I was by the pool when I first met her grandfather, Opa. He was wearing a blue farmer’s overall, and he seemed very old, and frail and I remember him shaking. She said that he’d fought in the war and had been taken prisoner by the Russians and hadn’t ever really recovered from it. Or was that her other grandfather, I can’t really remember, I know they’d both fought and at the time I’d not thought about it much. I was young and in 1979 the war already seemed to be ancient history. But now, I know that thirty-four years is no time at all, and I sometimes wonder what their stories were and where they might have stood in the turmoil that was Austria in the late 1930s and early 1940s.  

At the time I had no idea whatsoever about what had happened in Austria during the war. I guess I presumed that Austria was just another one of Hitler’s victims, but its story is far more complicated than that. The role that Austria and some Austrians had played during those dark years was very different to that played by the citizens of the other countries that had been conquered by the Third Reich. In 1938 for a great many in Austria National Socialism brought stability and jobs and as long as you kept your head down and you weren’t a Jew, or a gypsy or disabled, it brought security – at least for a while. But for people who were different or who resisted, it brought terror. I knew nothing of that then and I knew nothing of what had happened to children and people with learning disabilities. And if I had, if I’m honest with myself, I might not really have cared beyond platitudes.

It would be another 14 years before the first of my own children would be born and a couple more before people would begin to use the word “autistic” when talking about them. One day a paediatrician would use the term “Asperger’s” when referring to my eldest, I didn’t know then that it was a word that was intimately linked to Austria’s war and the role that some would play in the killing of disabled children. And nor did I know then that my youngest would be born with severe learning disabilities and that I would one day be grateful that he hadn’t been born in another place and at another time.

But none of this was in my mind as I stood by the pool in the house with the orchard, looking at the old man in the farmers overalls as he stared at me. Because the threads of time and place and identity that would one day connect me to the actions of the National Socialist Euthanasia program were still hidden.