Politicians can no longer pretend we can fix everything from the centre
Those of us on the left are advocates of the power of common endeavour to improve lives. Whether it is the NHS, social security or social housing, the history of social progress shows that it is through a common resource that individual needs are often best met.
Historically, the central state has been the key actor in delivering these advances. However, the interviews we have conducted suggest a different approach will be required in future. As Hilary Cottam of Participle says, ‘Everything – the thinking, the action, the design – needs to start from the point of view of people, not the institutions and how to reform them.’
This powerful insight is shared by all of the public sector innovators we talked to. Their experiences suggest that when you move from the national to the local, from the ‘mass’ to the individual, and from the state to the family, the role of public services as an agent of change looks and feels very different.
Five main themes emerge from the interviews.
The first is a clear understanding that, despite its best intentions, sometimes the state is not very good at doing what it is supposed to do.
When Gill Ruecroft and her team introduced personal health budgets for patients with mental health problems in Northamptonshire, it was because existing services were not improving people’s lives or getting to the root causes of their problems. When Cottam worked with troubled families in Swindon, she saw ‘what it really felt like when public service worker after public service worker came in to call and deliver a message and leave’.
Discussing weaknesses openly and addressing the need for change should always be welcomed by those who believe in public services. The people we interviewed showed that encouraging users and staff to be frank about problems acts as a spur to better service provision, not a reason to be sceptical of the value of common endeavour.
Looking back, Labour failed in the 1970s to respond to growing discontent among council tenants by creating new models of public housing provision that better met their needs. This failure opened up the space for the Conservatives to develop a solution which was purely market-based and individualistic. The lesson is that if Labour fails to adapt public services to new circumstances, falling public confidence allows the Tories to destroy them.
We cannot repeat that failure in this century.
The second theme is the need to challenge views about the value of a ‘big state’ presence in people’s lives.
Education aside, most people do not want to constantly interact with the state. We would rather be healthy than have to use health services. We would rather be employed than deal with social security. Most people are grateful they do not have contact with social services.
When you look at things from this perspective the challenge is often to help individuals and families extricate themselves from the services the state provides – not because the service is unnecessary but because the need for it symbolises problems that need to be fixed, and that the ultimate goal should be to remove the need for the service in the first place.
As Jayne Moules says of her work in Newcastle bringing together all of the different agencies that interact with families with complex needs, ‘One of the prizes we want to offer families is to say “by getting to this point you won’t need us, we’ll be out of your life.” Getting to the point where you don’t need services, you don’t need to be scared.’
Moules’ work suggests that, in many cases, what each individual needs is a route that takes them away from close connection with the agencies of government and towards greater self-reliance. The paradox is that finding this route requires the state to be at its very best.
The third theme is that the key to making lasting change lies in giving people real power and control over the decisions that affect their lives and the services they use. This is the new politics of empowerment, which offers the potential not just to improve public services but rebuild trust in politics too.
When public spending is being reduced, it is all too easy for any change to be attacked as cuts-led, but, in truth, changing services to better meet people’s needs would have to happen even if funding were more readily available. People are no longer prepared to be the passive recipients of whatever is offered to them. They want, and they deserve, the right to be involved in decisions taken about them. We need to realise, too, that decisions about public services will be better if they are informed by the experience and understanding of people on the receiving end.
This is not about shrinking the state but about giving people the ability to decide for themselves how they want the state to be present in their lives. The Tories have an ideological imperative to roll back the state; Labour’s challenge is to change the role of the state so it becomes a flexible tool that helps people improve their own lives on their own terms.
Fourth, there are many ways in which a state that hands real power to its citizens could prove to be more cost-effective. Whether it is through personal health budgets that reduce the use of emergency NHS care, or effectively integrating all the support for troubled families to prevent problems from developing, giving people greater power and control can reduce the need for extended use of more expensive services.
Empowerment offers Labour the chance to marry fairness with greater efficiency. Every pound spent ineffectively is a pound not spent on securing our economic future or helping those with the greatest needs. As our colleague Stella Creasy has argued, wasting money is not a progressive value. An ineffective state which fails to listen to people can have wider consequences too. As the old ways of doing things fail, people’s confidence in the state breaks, which can leave the door open to simplistic but false solutions propagated by the far-right or the far-left.
The fifth and final theme is that the challenge to do better can be very disruptive. That is as true for the private sector as it is for the public sector.
Jim McMahon ‘reset’ Oldham’s social care provision by creating Oldham Care and Support as an ethical care company. He shows how different models of service provision can be just as challenging to private sector failure as to weaknesses in the public sector. Addressing failures of both sorts is a powerful incentive for those who seek greater equality.
For practitioners, change can require understanding that well-trodden paths and long-established ways of approaching things may not always have been the most effective in terms of making changes that last. Making such a change might involve different ways of working and different cultural attitudes. It will seem risky and even dangerous. Change is always perceived that way, but that does not mean we can ignore the need for it.
As Ruecroft says, public sector staff are ‘quite nervous about [change] to start with’ and ‘there’s quite a lot of fear that actually they won’t be needed any more’. Similarly, Josh MacAlister reports resistance from social work academics who he argues have ‘a fear that the implication of this [ie new ways of working] being successful is they’ve spent some of their career doing something which could have been put to bed easier.’
The political changes that are required to give people more power and control can feel just as unnerving. We come into politics to change things for the better but for too many this means directing change from the centre without realising how taking control over people’s lives and communities can leave them incapacitated and weak. The new politics of empowerment needs politicians confident enough to understand that their challenge is to win power so they can give power away.
Making the case for change is always hard. When you cannot answer the question ‘What will you do about problem X?’ with a firm, national promise, it becomes harder still.
This is perhaps why, in McMahon’s words, ‘We’re not used to allowing for difference. We use the language of postcode lotteries, because we’re scared of different places receiving different services.’ Ultimately, though, McMahon argues that the public will see for themselves whether a programme is working. As he says, ‘The public can judge whether the local authority and other public providers are delivering’.
To a large extent, the last Labour government used central targets and increased budgets to drive public service reform. We need to move on from the New Labour era not because it was wrong for the time but because the world has changed and we now face new challenges in reshaping services so that they better meet people’s needs when there is far less money around.
This may not be as daunting a leap of faith as it appears. Trust in politics is low. Pretending we can fix everything when we cannot breeds scepticism about politics and politicians. There is no need to treat people as children by pretending there are simple answers to everything. A more mature political discourse would accept that the state and its citizens need to work together to find the right answers.
The people we have interviewed have shown a willingness to embrace criticism, then push past nervousness and the natural fear of change to hand power to those who know their own situation best. They have used the energy that this transfer of power unleashes to improve services without increasing costs or demanding increased budgets. We need to listen and learn from them, just as they have listened and learned.
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Liz Kendall MP is shadow minister for care. Steve Reed MP is shadow minister for home affairs
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Download the full pamphlet, Let it go: Power to the People in Public Services, here