radical help - hilary cottam

P.17 Over ten years we created five core experiments, and each one forms a chapter of this book. We considered the challenges of families such as Ella’s, families that are locked out of society without work, health or hope : a very modern form of want. We looked at growing up and the transition into adulthood. The teenager was a concept that had not been invented when the welfare state was designed ; today we know these years can be tough but also formative, so we wanted to know what support is needed. We looked at work, which is being transformed by global forces including the digital revolution : what support do we now need to find and create good work? We looked at health : at the modern disease of the mind and body that now absorb most of our health expenditure, but which went unrecognised or were unknown when the welfare state was devised. And we looked at ageing. It is largely as a result of the welfare state that so many of us are living longer, but our needs in later life are putting intolerable pressure on existing institutions and suffering is widespread.

P.18 The experiments showed us, through practice, what need to be the principles of modern systems. Modern welfare must create capability rather than manage dependence ; it must be open, because all of us need help at some stage in our lives, and when we are thriving many of us have help to offer ;

P.57 ‘Change — how?’ The mothers yell back. ‘You are just telling me to change. How’s that supposed to happen?’

P.116 The economist Carlota Perez has been studying the links between technology and broader social change for decades, as she seeks to understand and explain what she calls techno-economic paradigm shifts : the seismic changes in how we produce, consume, live and work that are driven by changes in technology. Work, welfare and technology are closely connected. As each wave or shift comes — the invention of steam power, the railways, the car or the computer — there are periods of crisis as societies adjust and the new technologies distribute their effects throughout our lives : changing patterns of work and creating new forms of leisure and communication. When we see these interconnections we can move beyond an obsession with individuals and how to move them into work. We can see instead the wider patterns of change and we can think about the systems that would better support us in navigating these rapid, deep shifts. ⠀The current digital transition is still in the early phases and the implications are not fully known. Some proclaim that there will be no work — a challenge I return to at the end of this chapter. What is clear is that we are undergoing a revolution, and employment services are out of step. We may have computers on the desks, job searches carried out online and Jobcentres offering courses in digital skills, but the operating framework is still that of mass production : process the claim, get people into a job, pretend that the job will last and close your ears to the fact that derisory wages mean only a fool would want half the jobs on offer.

P.135 The unions were important agitators for a welfare state and for decent employment. But today the unions, like Beveridge’s welfare systems, have become rigid and defensive, more able to protest than create. Of course many in the union movement know this, and a younger generation reengaged in ground-breaking work to rethink their structures and their activities. My point is that, just as in the Industrial Revolution, we need other reinvent a wide range of organisations, including the unions and the further education sector, and we need to connect different spheres of the economy in new ways.

P.143 It is no longer appropriate to continue with our existing systems, to persevere with programmes of efficiency or to tinker with new methods of payment that might, for a time, prop up the NHS. We need to have the courage to address the much more profound redesign that is needed. We must embrace the challenge because we cannot continue along the same path. In our new reality the cure — the idea on which the NHS was based — is not available because our ailments are not curable. We need to pivot.

P.150 Story-telling is not a recognised tool of social policy, but the power of stories is understood in the ‘psy’ disciplines

P.169 We can attempt to dam the flood, or we can work with the tides.

P.197 Our current welfare systems have a logic that runs like this : assess me, refer me, manage me. These systems count inputs (buildings and professional time) and outputs (reduced risk behaviours). They restrict access and try to manage costs.
⠀The experiments proposed a different logic :
⠀Foster a core set of capabilities so that each and every one of us can thrive. Ensure, where necessary, that we are supported in the face of adversity. Include as many people as possible. Measure change and the quality of our lives : our sense of freedom, purpose, of having something to give and our connections to one another.

⠀This is radical help, and there are six core principles that constitute this new framework. Each represents a shift from our current practice to a new way of thinking and doing.
1. Vision : the good life
2. Capabilities
3. Above all, relationships
4. Connect multiple resources
5. Create possibility
6. Open : take care of everyone

P.229 What’s wrong with the focus group? Focus groups are efficient : they can garner rapid reactions to a set of given ideas. But participants in focus groups are known to have a tendency to talk about what they already know, and new ideas are really produced. Instead, focus groups often suffuse improvements to the existing system :

P.242 The questions that need to be asked are these : can we seed the models in new places so that they can take root and be grown locally? Can we connect more and more people to the networks and platforms? And can we do this in a way that remains true to the principles, while enabling local adaptations? I know we can.

P.248 Transition involves protecting the work long enough for change to take root.

P.255 When you see yourself as part of the future you embrace it. Conversely, if you see that you might be left out or you feel that something will be done to you, you feel critical and you may resist. Growth reduces the challenges of transition. The more we can grow, the more we can include people in these new and liberating structures, the smoother the transition.

P.270 We can do it. We know this because we have been here before. The institutions, systems and arrangements we live with were born out of crisis. They have worn out now. But I return repeatedly to the stories of the post-war welfare state because they remind us that new and sweeping change is possible.

P.274 What I could not see at first, and had to learn through practice, through observing, listening and through the new forms of measurement we designed, was that relationships are the element that matters, the foundation of a new system, the new framework within which we must create. … ⠀We know what to do : don’t let’s wait for permission from someone else.