Simon Duffy

Thoughts, Bemusements & Arguments

Tag: civil service

Living in the Ghetto

I was recently invited to speak to a room of commissioners for services for people with learning disabilities in England. This is a pretty rare event for me these days and so I was keen to make the most of the opportunity.

I called my talk ‘Who Put Out the Fire?’ and I wanted to talk about why there no longer seems to be any significant passion or momentum for inclusion or for further deinstitutionalisation. I do not mean that nobody is doing good work. As ever, there are brilliant people doing wonderful things across our communities. But overall the passion that used to exist to bring about positive change has evaporated. In fact, in some places, we see things going into reverse.

We are at a moment of change.

Progress is not inevitable and we should not be naÏve. Things are beginning to roll backwards and, unless we change our behaviour, things will get much worse. Eugenics is already back on the agenda, in the form of genetic screening for Down Syndrome, ongoing practice in neonatal care and abortion laws that abandon limits in the case of disability. These practices go hand-in-hand with the meritocratic beliefs of our elites – people who think that the ‘clever’ (themselves, by their own definition) deserve the ‘best’. Putting powerful technology in the hands of people who think that they are better than other people never ends well.

And the institution is back. Not only are thousands still incarcerated in private hospitals (at great expense) but also authorities are now being tempted by that old dreadful excuse for bad practice: economies of scale.

Some of this can be explained by austerity. Politicians and managers have always been tempted by the idea that ‘congregate care’ must be cheaper and that they have a public duty to manage costs and be ‘reasonable’. This is understandable when local authority funding has already been cut by 30-40% and is being further cut today. Local commissioners are only following the lead of national politicians when they shift the burden of the banking failure onto disabled people and families.

However, more controversially, I think that some of the responsibility for today’s failure of leadership lies with Valuing People. I do not mean that the Valuing People policy or its leaders were bad – quite the opposite – but I do think the whole process has led us up a creek and today everybody seems to have forgotten how to paddle. Genuine, community-based leadership, is missing in action.

In the 1960s and 1970s many leaders emerged, inspired by Wolf Wolfensberger’s ideas, shocked at the state of our institutions or simply keen to ensure their sons and daughters were able to get a better deal. These leaders challenged the norm and created new alternatives. Many of the organisations (like Mencap) which we take for granted today earned their leadership status through this process of challenge and creation. Later on other organisations, like the Campaign for Mental Handicap (which became Values Into Action) took on the role of challenging Government and of advocating for human rights and inclusion.

But Valuing People encouraged people to put their faith in two dangerous myths. First, that Government did care, and would continue to care, about the fate of people with learning difficulties. It didn’t, it doesn’t and it won’t. Second, positive change comes from Government and from the leaders it selects.

By this I don’t mean that Government is bad or hostile to the interests of people with learning difficulties. It isn’t. But Government is always late to the party. The job of a civil servant is to keep everybody happy, not to lead radical change. The job of a politician is to respond to democratic pressure, not to stand up for powerless minorities. Entrusting leadership to politicians and civil servants is to abandon leadership.

It seems to me that Valuing People killed the real drive to inclusion; just as Putting People First killed the drive to self-directed support. Killed with kindness, killed with money, killed by assuming an intellectual authority it could never possibly live up to.

This seems counter-intuitive. Too many good things, too much useful funding and too many opportunities are associated with Valuing People to believe that it was bad for us.

But look at England today.

Where is the self-advocacy movement? In tatters. Today the Government is about to take away the last piece of funding for the National Forum and for the National Valuing Families Forum. If this goes then can we look back on over 30 years of self-advocacy development and congratulate ourselves on our achievements? No. Self-advocacy is patchy, under-funded and lacks any agreed form of leadership.

What about service development and innovation? For some reason we now expect government and commissioners to lead innovation; but our systems of commissioning have effectively killed off innovation and creativity. Some people and families have escaped the system, using direct payments; but most of the money remains invested in the care home system (which is now protected from the impact of personal budgets).

Today the whole sector seems incapable of defending itself or of uniting with others to fight for justice. For example, there is no effective campaign to defend social care. Many of the leading organisations seem too dependent on Government funding and unwilling to speak out or get organised.

If you look upwards for rationality and for inspired leadership you’ll be a long time waiting.
The positive changes that began in the 1970s were led by people and professionals, starting from where they were then. Focused on what they could do with the resources they had to hand. They did not expect everything to be done for them. They got organising, supporting and campaigning. That’s how things really change.

Perhaps one thing that they also had back then was a strong sense that the current system was unacceptable. They looked at the institution – those systems of absolute exclusion – and they declared that it was absolutely wrong – and they then worked hard to build an alternative.

In practice that alternative is the world er have now: group homes, day centres, respite services and care services. This is a significant improvement over the old system. This is the system that is today’s ‘normal’. This is the system we are struggling to improve and which is now beginning to slip backwards into something worse.

Why can’t we do better than this?

What can’t we dream bigger than this?

People with learning difficulties are agents of social change. They can bring communities together, they can break down the barriers of pride and illusion that leave us dislocated and alone. They can offer the rest of us a different sense of the purpose of life and insight into the joy of living.

People with learning difficulties are just different. But we are all different… get over it.

Diversity is a good thing and to be welcomed. True equality is not found in sameness, conformity or compliance. Equality means treating each person as if they belong, as if their gifts have meaning and value. Equality demands we treat each other as citizens – working together to create communities that welcome and nurture our gifts.

If you believe this then this belief has real life consequences.

One of these consequences is that we must start to acknowledge that the community care system, that was developed during the period of deinstitutionalisation, is totally inadequate. It is a system of ghettos, small segregated communities, cut off from community life and communicating to people on both sides of its walls that people with learning difficulties don’t really belong in our communities.

Ghettos are not evil. Community care ghettos are not the same as the long-stay institutions that they replaced. Ghettos can even be fun and interesting. Ghettos can even convert themselves into places of community and inclusion. (It would be a mistake to confuse ghettos with institutions and it would be a mistake to ‘close’ ghettos using the same kind of process that were used to close the institutions.)

The architects of new and inclusive communities will be people themselves. But they will need help from families; and they will need help from the professionals who want to be true partners. And they will need help from fellow citizens who want to live in the kind of community that can welcome each of its members.

Is this progress inevitable?

No. Today it’s being undermined by powerful social, economic and political forces that are being left unchallenged.

Is this progress a pipe dream?

No. It is happening now, in small pockets. There are people and places that are showing us the way forward. Rising to this challenge takes work, it takes time and it takes creativity. But it’s worth it.

What I am trying to do is reframe the challenge that lies before us. We must stop treating the current community care system as if it provides an acceptable norm. It does not. We have to be honest about the limitations of what we’ve achieved. There will be no increased hope, passion and wider social movement unless there is both a compelling vision for inclusion and a growing sense that the ghettos we’ve created are unacceptable.

We’re Getting Older – Don’t Panic, Don’t Panic!!

Some days seem to have a curious symmetry to them, and this week I have had one of those days. It began in the heart of the Whitehall and it ended in a community radio station in East London; but the theme at the heart of the day was constant: what does it mean that we are now living longer?

The first discussion was a roundtable with some of the leading academics and experts in health and social care. (If you are wondering why I was there then you are not alone; I don’t know either, but I was certainly happy to have been invited.) It was chaired by the excellent Professor Martin Knapp of the London School of Economics and we were being asked to think about the implications of ageing on health and social care.

I was asked to say a few words about the impact of longer lives on our ability: “to provide and procure care” although, as I tried to argue, I think this is entirely the wrong way to frame the question. The real question is “how do we support each other as we live longer.”

What I tried to communicate was that there is no evidence that our growing health, and our longer lifespans, will create any crisis. These facts should be a source of celebration. Yet, there is almost no social change, even social progress, which cannot be turned into a crisis if it’s handled in the wrong way.

In my presentation I used data from a report by The Centre for Welfare Reform that we will be publishing in a few months. I had carried out an analysis of of disability, healthcare, social care and community capacity in Barnsley, where:

  • 2% of the population were in very bad health
  • 7% were in bad health
  • 13% had a disability (this group will overlap with the first two to some extent)

Barnsley spent £60 million on social care, however this figure is dwarfed by the care that the citizens of Barnsley provide to each other without pay.

If Barnsley had to pay for the support that is already being provided free, by carers (the official jargon for family and friends) then it would have to spend about £600 million. In other words the support provided by families is about 10 times greater than the support paid for by the community via taxation.

Furthermore, we can go on to estimate how much time and energy is potentially available to the town – what we could call its ‘community capacity’. You can do this by looking at how many people live in Barnsley (about 250,000) and then taking away all the time spent on being a child, time lost to paid work, time in education, time spent caring and time used for ordinary amounts of rest and leisure. This leaves you with an estimate for how much ‘community capacity’ is available. For Barnsley that is equivalent 65,000 whole time equivalent people, with an economic value of over £1 billion.

There is an army of community capacity potentially available to any community (unless its working too hard) and this capacity is probably over 20 times greater than what is spent on social care.

We are society with immense financial wealth, in addition we already have all the human capacity necessary to provide the care and support that we need to look after each other. We will all go through the shared human experiences of sickness, age, disability and death; but we certainly have the resources necessary to ensure that we can all do this in ways that ensure our dignity and mutual respect.

If we focused on our immense community capacity available then there would be no sense of crisis. However community capacity is undermined by a series of negative factors that are driven by Government policy and by the interests of the powerful:

  1. Cuts to social care – Local government funding from central Government has fallen by more than 30% in 6 years and is projected to fall further. Central Government funding used to provide 75% of local government finance. Cuts to social care have been deep and we have seen the number of people supported fall by well over 30% in the same period. I assume that local Government has had to cut its most efficient and low cost supports first, leaving it with a growing percentage of its budget invested in expensive and institutional provision, which is harder to cut. I do not see how the obligations of the Care Act 2014 can be balanced with the desperate situation of local government.
  2. Means-testing of social care – The extreme means-testing of social care does what all means-testing does – it reduces social solidarity and encourages people to divest themselves of their own wealth if they are at any risk of needing social care. This further undermines community capacity and faith in the community’s capacity to support people to get the necessary additional finances they need when illness or disability develops.
  3. Inequality and poor productivity – The UK is the most unequal country in Europe with low productivity and high employment rates. Or to put this another way, more people are having to work longer hours to maintain even a very modest income. For instance, increasingly both partners in a typical family need to work to maintain a modest income, leaving less time for caring or for citizen action. Economic inefficiency and extreme inequality both have the impact of minimising available time for citizen action and community capacity.
  4. Workfare and the collapse of the voluntary sector – There are two powerful but inane dogmas that dominate public policy in the UK: (1) the only useful activity you can do is earn a salary and so pay taxes and (2) the best people to find people work or volunteering opportunities are the DWP or their private-sector agents. Clearly these ridiculous assumptions undermine our ability to tap into people’s real gifts and skills.

So it seems we are in the process of turning what is an opportunity for a longer richer lives into a severe social crisis. We lock a higher proportion of our increasingly limited financial resources into professionalised and institutional care; so we will then be only able to offer support to fewer numbers of people who will be in severe crisis. Alongside institutional care, micro-institutionalisation and the misuse of technology to ‘keep people safe’ will probably grow. At the same time fewer families will feel that they can afford to take care of their own relatives and will so demand ‘care’ from a system that will not be able to offer them support until they reach breaking point. The ongoing pressure to allow euthanasia is consistent with this crazy system problem.

The sad thing is that, while there are so many clever and well intentioned people in the central and local government, it just seems impossible to shift discussion away from the minor problem of ‘funding social care’ to the major opportunity of ‘supporting community capacity.’ It is cynical to think that this is only because a crisis is much more useful to the political elites, but Mencken’s often quoted proposition does sometimes feel so true:

“The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.”

Perhaps, but I hope this is not true, the powerful do not want to recognise that releasing community capacity is about freedom and empowerment. The real solutions we need – those generated by people, families and communities – all require freedom and creativity in order to exist. The great innovations we are seeing from organisations like PFG Doncaster, WomenCentre, IBK Initiatives, Best Buddies UK, and so many more, are all rooted in an awareness that we are free citizens who can choose to act to benefit ourselves and our community.

Capacity is rooted in the actions of free citizens, working together in community. Such capacity cannot be bought, it cannot be bossed, it can only be enabled, supported and liberated.

Despite my fears it was encouraging that so many in the discussion did share my sense of disquiet at the danger of accepting inequality and an on-going public service crisis as the inevitable background to policy-making. But one could still feel the gravitational pull in our discussion of these hobgoblin problems: the fear of increased costs, the fear of increased rationing and fear about what will happen to us at the end of our lives.

After this discussion I was lucky enough to be invited to East London Radio, to be interviewed by Mervyn Eastman. Mervyn Eastman is an inspiring leader and social worker who has established the Change Agents Coop with the wonderful Cheryl Barrott. The Centre for Welfare Reform has recently joined the Coop as an organisational member.

Together we discussed how the idea of citizenship must become central to our thinking about ageing. Citizenship, everyday citizenship, is the foundation for building a good life for ourselves and building good communities together. We explored how old age was not a problem; but a society that insists on treating it as a problem will certainly end up creating one.

What made this radio interview especially sweet was that I was able to indulge my love of music. A rather sad admission on my part is that I have always dreamed about what I would choose if I was ever invited on Desert Island Discs or on Radio 3’s Private Passions. For East London Radio I picked:

  • Communication Breakdown by Led Zeppelin
  • The Nightwatch by King Crimson
  • Anyway by The Roches
  • A Survivor from Warsaw by Arnold Schoenberg

As I left the studio, to head home to Sheffield, I found myself in the community cafe and bookshop that was also the home of the community radio station. On the shelves were some fantastic European novels I’d not heard of and so I indulged myself by buying 4 books to take home.

So my day ended with this sense of contrast. On the one hand, in the bowels of Whitehall, intelligent people were struggling, against the grain, to stop the system turning old age into a new social problem. Meanwhile, on the streets of East London, ordinary people were busy building, sharing and supporting one another to lead richer, better lives.

As ever Christ’s words help. The Vulgate puts it as “sufficit diei malitia sua” which could be loosely translated it as: Start by tackling today’s injustices.

If Government really wants to help us ensure that we can take good care of each other in the future then there are four pressing problems it could tackle now:

  1. Protect social care funding
  2. End social care means-testing
  3. Radically reduce income inequality
  4. End the stigma and control of the DWP’s benefit systems

Do those 4 things and human capacity will flourish and many of tomorrow’s problems will never arise.

Robocop and the Civil Servant

I recently watched the remake of Robocop. It was not a very good film, but it did remind me of the plight of the civil servants in Whitehall and the challenge of how and when to use your conscience.

Hannah Arendt defined bureaucracy as Rule by No One. It is the office that is accountable, not an individual, and that really means no one is responsible. Who, for instance, was responsible for making up fake stories that give the impression that sanctions for people on benefits are fair and reasonable? No one. It was just another bureaucratic task required of a civil service that must carry out the ‘will of the people’ who, in this instance, have been ‘realised’ in the form of Iain Duncan Smith.

Back in 1988, as a young man, having left University with little idea of what I wanted to do, I applied to be a ‘fast-track’ civil servant. I got through the exams, but then went to Whitehall for an intense couple of days trial by interview and workshop. One of the interviews was with a psychologist who asked me what I would do if I was asked to do something that I thought was wrong.  My simplistic response was that I wouldn’t do it; but the psychologist argued that this would not work in the civil service, for you would have to work with politicians of every colour and they were accountable to the democratic process. It was not for me to insert my sense of right or wrong, like a spanner, into the workings of Government. The psychologist also went on to suggest that guilt was a bad thing and that perhaps I took it too seriously (a proposal I didn’t accept). I was then offered a job as a Tax Inspector (which I turned down).

While I can understand the logic of this argument for a neutral civil service it was clear to me that this was not my cup of tea. Moreover, I do wonder whether we really need a civil service.

This came back to me watching Robocop. For those of you not familiar with this science-fiction classic, a policeman, who suffers severe trauma is encased in a robotic suit – hence Robocop. But most importantly, to increase his effectiveness as a policeman, his conscience is ‘turned down’ by a combination of drugs and computer over-rides so that he cannot really be in control of his actions. Of course, it turns out that he is working for a corrupt system and he has become a tool of injustice. The story hinges on his ability to break free and assert his own will and conscience.

I know most civil servants are good people in a difficult situation. They are being asked to do bad things by a legitimate Government that has been elected by 24.4% of the electorate. They are well paid (civil servants have the highest median salary of any group – public or private) and they live in the wealthiest part of the country. They are surrounded by the powerful, the famous and the persuasive. It is hard to imagine circumstances more liable to put conscience to sleep.

Yet, stirring inside them, many must be this question: Did I really enter Whitehall to impoverish the poor and bully the weak?

And those of us outside Whitehall must be asking a further question: Do we really need civil servants if they can do things like this?

The model of the neutral civil servant, the tool of Government, seems so reasonable. But do we really want politicians to be given this kind of power over us? Could we take back this power and make decisions ourselves – in our lives and in our communities? How might we limit or discipline the spread of this kind of unaccountable power?

The ancient Athenians actually filled many public office by lot – subject to some vetting – like jury service: “It’s your turn to head up the collection of customs.” The main thing, as Aristotle observed, was to make sure that nobody had any personal interest in the decisions and so no temptation to cheat. And as they were only in post for a short while, and could be held accountable by the public – their fellow citizens – this system worked well for several hundred years. Perhaps we should try it too.

© 2017 Simon Duffy

Theme by Anders NorenUp ↑