Ruth Dineen says we must end state services that define people as unemployed, homeless, ill or infirm
Anna Coote of the New Economics Foundation believes that the traditional model of public service delivery “has disempowered those people who are most in need of care”. She suggests that unless we “re-align the relationship between the state and citizens, we will be left with both in disarray: an unsustainable system and citizens who will have to fend for themselves”.
Arguably that prophecy is already coming true. The traditional approach to public services tends to be deficit-based. People (and communities) are defined by their deficiencies – as unemployed, homeless, ill or infirm. We expect public service professionals to fix people’s problems, casting individuals in the role of passive and inadequate recipients with little or nothing to contribute. The result is an increase in both dependency and need.
This is problematic in its own right. However, at a time of economic decline, an ageing population, welfare reforms and increasing social inequalities, it is catastrophic. So what’s the alternative?
Let’s imagine a different future. One where all care homes are lively, loving places where residents have choice and autonomy in their everyday lives. Where young homeless people help to solve problems of anti-social behaviour and generational conflict in their own neighbourhoods, and where high school pupils work in partnership with a national children’s charity to raise awareness of domestic and sexual violence. Where mental health patients collect stories from their peers and use their expertise to improve the service they receive.
Imagine a community whose members contribute over 30,000 hours of ‘official’ voluntary work each year – and many more hours in an unofficial capacity. Imagine a substance-misuse initiative where former service-users run a highly effective peer-mentoring scheme. Or imagine a local authority who co-commission children’s services with the help of the children themselves.
This imaginary future already exists in Wales. It’s called co-production and it offers a sustainable, evidence-based response to the crisis in our public services. Co-production is about citizens and professionals pooling their knowledge and experience to identify and solve problems. Its use results in more effective and more relevant public services. It also increases engagement, builds stronger communities and improves wellbeing across the board. It’s not the Big Society. It’s a return to the Welsh traditions of co-operation and community. In Nye Bevan’s words, it’s “collective action to lift all of us together”.
Co-production principles can be applied to all public services and in every sector. This is not about imposing yet another simplistic model or chasing the latest neoliberal chimera. It’s certainly not a modish quick-fix. It’s about creating the conditions for people of all ages to be valued within their schools, homes, neighbourhoods and communities. It’s about appreciating who they are and what they can offer.
It’s not doing it for people, but doing it with people. In a co-production scenario, service-users and their communities are involved in defining the need or problem, designing the solution and delivering it, either with professionals or independently, or anything in between. This approach demands longer-term engagement by service-providers but leads to profound and sustainable change.
More challengingly, co-production requires both a shift in power from service providers to citizens. It also requires a cultural change from mechanistic, risk-averse forms of delivery to relationship-centred approaches. We need to re-think what we mean by professionalism in health and social care and re-examine our ideas about risk management and professional boundaries. We need to move away from procurement and quantitative targets to co-produced, outcomes-based commissioning. As a UK Cabinet Office report put it last year, the potential prize is “enhanced, more cohesive communities; services that are more efficient and responsive; and increased opportunity and influence for individuals”.
All in this Together, the campaigning body for co-production in Wales, aims to make co-production the primary approach to our public services. We are working with public service professionals, civil servants, commissioners, academics and citizens to raise awareness of co-production, to share best practice and build the evidence base.
What’s needed now is a clear, visionary lead from the Welsh Government. As part of our campaign, tomorrow we are sending an Open Letter to the First Minister and the rest of his Government, asking that co-production principles are placed at the heart of public services in Wales. The Open Letter has 250 signatories from individuals and organisations in Wales.
We will also forward the many letters of support we have received from co-production advocates from USA, Australia, England and Scotland. They include:
- Edgar Cahn, American civil rights lawyer and a founding father of co-production;
- Philip Colligan of Nesta’s Innovation Lab;
- Anna Coote of the New Economics Foundation;
- Dr Simon Duffy of the Centre for Welfare Reform; David Robinson of the Early Action Task Force;
- Will Norman of the Young Foundation;
- Sarah McDonnell of the Office for Public Management.
- Eddie Bartnick, Western Australia Mental Health Commissioner.
If co-production principles are embedded on the face of all relevant legislation, regulation and codes of practice, this would act as a powerful catalyst, helping to consolidate the shift already evident in Wales towards equal and productive state-citizen relations, based on reciprocity and trust.
There is ample evidence of co-production’s capacity to deliver this vision, creating more humane, more effective, and more sustainable public services. There is also ample evidence to suggest that if this opportunity is not grasped, our future will be characterised by “an unsustainable system and citizens who will have to fend for themselves”.
Ruth
We need to look at how these principles are embedded in Sustainable Development Bill.
Peter
Really interesting article. I’ve seen a number of Communities First partnerships who have sought to embed co-production into their work, and the results have been impressive in highlighting people’s passivity in the face of the state more than anything else. But I have a nagging feeling that we’re still looking towards reform within the public sector to fix what to my mind is a greater structural problem. Until the tools exist to fulfil people’s real needs – primarily, I’m talking about employment – then weaning people off over-reliuance on the state is going to be a painful and ultimately fruitless exercise.
Our ownership of the public sector means that we can reform it, we have levers to manipulate its direction. But as the article holds that “Co-production principles can be applied to all public services and in every sector”, surely THIS is the real task? I for one would love to see the principles of accountability and user engagement applied to the private sector.
Can we have a few examples of co-production in action? I found this article intriguing but rather abstract and I struggled to visualize what organizations might do concretely and in practice to achieve the desired outcome.
Picking up on some of Jack and Tredwyn’s comments.
It’s really easy to agree with the principle of co-production as put forward, but it is the ‘how to make it happen’ that is the challenge. If I would say one thing to Welsh Government it would be, get behind some meaningful pilot work in Wales. There are support providers out there who want to work on this, there are university researcher departments who can help, and importantly there are people and family members who can tell us whether they can ‘feel the difference’ that co-production is making.
So, Jack commented that he thinks there is a greater structural problem that needs to be fixed. I suspect you’re right Jack and it would take a greater brain than mine to know what that new structure needed to be. However, I think that it is meaningful pilot work that will inform and shape structural change, not by leading to any great eureka moments, but by all stakeholders learning as we go. Its the learning that needs to be co-productive in the first place I think.
Deb –
Sorry, I realise it does look like I just highlighted a problem without really addressing the role of co-production in solving it! My position is that I have seen co-production in action and seen its irrefutable benefits, but that the end-products that it will doubtlessly be judged against are essentially outside of the its control. For example, co-production can help a community to identify training that they feel would help employment prospects, and education providers can give extra-mural provision to match this, but the missing part is the employers themselves! Having input from key employers could help to limit skill-mismatch in the economy as well as sourcing vital work placements for young people. I’ve seen this happen in the construction industry, where input from communities encourages large firms to go above and beyond their social responsibility. The trick as I see it is to involve them from the off, so that they can become stakeholders in the process as well as public agencies and communities.
Tredwyn – I believe the Anglesey & Gwynedd Recovery Organisation (AGRO) is an example. A recovery organisation run by people in recovery for people in recovery.
In this instance recovery refers to getting the better of alcohol and other drug problems. All across Anglesey and Gwynedd people in recovery are hosting meetings and activities that allow those in earlier stages of recovery to meet with other people who have been through what they are going through.
This approach provides positive role models, illustrates that recovery is possible, builds social capitol, and gives people a space to give something back and help others – which in turn builds their confidence and abilities to do even more. Members decide on the activities they would like to do from walks, fishing, bowling, cinema trips, they’ve developed allotments and are planning a round Wales road trip to meet up with other recovery groups in June. Together they make it happen with some support from AGRO.
AGRO provides the resources to support these member-led initiatives, like rooms to meet in, transport if needed, some central coordination and occasionally a little financial assistance. So AGRO is member-led, with a board made up of mostly people in recovery along with some other experts who provide oversight and assistance as needed.