Most people who are thought to have power don’t think themselves they have power.
Let’s look at those thought of as traditionally having power.
In the world of health, we hear about the “power” of the clinician over the “patient”; in care the “power” of the social worker over the “service user”. In the world of services the commissioner is the most powerful, and in the civil service we think that power resides with (Prime) Ministers or Permanent Secretaries.
Inevitably, the person at the top of any organisation is often thought to be the most powerful: the higher you go the more powerful the people get.
And, to some extent, this is true: their decisions affect larger and larger numbers, whatever those numbers happen to represent (people, staff, money).
So how can it be that the person thought of as the most powerful in the world can lament his own lack of power?
It goes back to my opening: if you ask those people listed above who are traditionally thought to hold power, I doubt very many of them would feel anywhere near as powerful as they are perceived to be by other people.
Take a social worker: from the point of view of someone who uses care services the social worker is incredibly powerful: they potentially determine what money you do/don’t get and what types of services you can access. But if we ask the social worker about their power they will talk about the pressure of their caseload, the policies they have to implement, the limited number of providers that exist on their patch, the pressure from their manager, and several other factors that all act to curtail their power to act.
Ask the social worker’s manager if they are powerful. They’ll probably laugh at you and say they have a team of social workers completely under the kosh who don’t fill out paperwork in the way they should do. They’ll be harangued by management for implementing lovely sounding changes there is actually little resource or appetite to put into practice. They’ll be getting phone calls from providers at all times about placements that are breaking down, and they’ll be pestered to complete monitoring data they’ll never see again by people they’ve possibly never met.
Commissioners in the same area will be thought of as having the power because they hold the purse strings. When they look up from reading the scant information about the latest priority they have to reflect in commissioning intentions with no new money, alongside the 78 other priorities they’ve been given, they’ll tell you that big providers call most of the shots, or that health commissioners are in the driving seat now. For what it’s worth, the supposedly powerful providers will tell you they’re being asked to do more and more for rates that are decreasing rapidly whilst under greater regulatory scrutiny.
At the top of the care staffing pyramid, the director of social care will tell you about the unrelenting pressure of upward demand, downward resources, their obligations under the Care Act, the threat of judicial review from any one of tens of families who have been treated poorly by their department, a recalcitrant workforce working in a culture that can’t be shifted, and the waffling politics of their portfolio holder and the local health and wellbeing board. They want to do good stuff in and for their local area, but the politics (big ‘P’ and little ‘p’) significantly curtails them.
And on and on it goes: “powerful” people for whom power is little more than juggling clouds.
What to do? The only reflection I can give is to try to recognise:
- The person you think has power probably doesn’t think themselves they have power
- Helping them in their relatively powerless position will probably help you as well
- To someone somewhere in the system, you are the person with power.
 – There is, of course, a vast literature on all types of power in a variety of different settings. I’ve not gone into that at all here, but a useful starting point for the interested reader is Chapter 10 of Fred Luthans’s Organizational Behavior (pdf).