Breadline or Left Behind: social work schemes for graduates from the university of life

Frontline and Think Ahead are new routes into children’s and mental health social work respectively for graduates with a 2:1 degree or better. The principle behind them – derived from Teach First – is to attract the “brightest and best” into a job / career they may not otherwise have considered.

My feelings about these social work training programmes have developed over time. Initially I wasn’t keen, but now I feel that anything which promotes social work as a good profession should be, broadly, welcomed.

How my feelings have developed have probably reflected the way the programmes themselves have been refined since their inception. Where before there was arguably an elitist, Oxbridge focus on who the programme’s participants might be, now it feels they’re much more interested in good graduates from a broader set of universities.

I wonder, though, if by focusing only on people graduating from university with 2:1s or above we’re missing an opportunity?

What if, as well as this, we had well-resourced and targeted recruitment campaigns focused on bringing people into social work who are likely to graduate cum laude from the University of Life?

These would be people who never made it to university; a high proportion of them probably wouldn’t have A-Levels. They will have faced adversity at many points in their lives and been used to navigating a whole host of difficult environments. But, despite the many challenges they will have encountered, their character, resilience and way of thinking has meant they have flourished.

If people like this became social workers, imagine the experience and perspectives they could bring to social work! Imagine the difference they could make to people whose lives they would truly understand!

We could call such programmes Breadline or Left Behind – anything that reflected the exact opposite of what Frontline and Think Ahead represents. Without denigrating these existing schemes, though, I think we’d find ourselves with another group of people whose contribution to social work could be significant.

Now, if only we could a think tank to take up the idea…

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It’s person-centred, Jim – but not as we know it

We all have our favourite “I can’t believe that actually happened” stories in social care.

Mine relates to care and support planning: whilst observing a panel process (error number 1), a Head of Social Care instructed a social worker (error number 2) to change a support plan so that all sentences were “I” statements (error number 3) from the point of view of the patient [sic] (error number 4), without going back to the person themselves (error number 5).

It would be funny if it weren’t so normal.

But we hear variations of this all the time, summarised in the line:

Of course what I do is person-centred care – it always has been

If we are honest, relatively little of what currently happens in the care and support system is person-centred (though we’re definitely moving in the right direction).

This being the case, we should ask ourselves: if it isn’t person-centred, then what is it? I think there are at least four alternatives:

  1. Money-centred care: where what people get is what commissioners can either afford, currently buy, or have always bought
  2. Provider-centred care: where the primary objective is to ensure the ongoing feasibility of an organisation rather than the people it serves
  3. Process-driven care: where filling out the paperwork or keeping the IT system happy is the main driver
  4. Professionally-driven care: where the professional knows best and tends to think of the person in front of them as another one of their caseload or a walking set of conditions

Thinking of it in this way shows why the drive to person-centred care has been so difficult: it requires significant change on a number of major fronts – the flows of money, the role of providers, the supremacy and comfort of process, and the culture of professionals.

It’s why I’m personally so excited about person-centred care and what it means for the future. It isn’t just an optional variation of what we’ve always done; it flips public services as we know them on their head. To make this happen, though, we need to be clearer on the alternatives that being person-centred is replacing.

What politics isn’t

In recent posts we’ve noted what politics currently isn’t: neither civil nor balanced.

Chris Dillow also notes here what politics isn’t, through the eyes of people who are interested in what passes for politics:

Most of those who claim to take an interest in it are not really interested in how to govern the public sphere: if they were there’d much more interest in the social sciences. Instead, they’re mere spectators in a wrestling match who are booing baddies and cheering goodies.

I cheered – well, sighed – reading this.

This begs the question: what is politics?

We’ll need to go back to Plato, Aristotle, Hobbes and Locke to get started on this. At least, though, we’re asking the right question.

 

Obama’s civility in a polarised world

We wrote last week about political polarisation, through which we include two different-but-related things: (1) exaggerated debate about public services being the norm; and (2) the role of interest groups in polarising politics.

Then up popped a video comparing Barack Obama and Donald Trump’s ways of dealing with hecklers:

This echoed David Brooks’s piece reflecting on the civility of Obama’s presidency, and the fact we’ll miss it when it’s gone:

Obama radiates an ethos of integrity, humanity, good manners and elegance that I’m beginning to miss, and that I suspect we will all miss a bit, regardless of who replaces him.

What I note about Obama is that he always plays the ball and not the player. He engages in the debate and doesn’t resort to name-calling, ad hominem  attacks or the tone someone employs.

As you would hope, he engages at the upper scales of the Hierarchy of Disagreement:

DH0: Name-calling

DH1: Ad Hominem

DH2: Responding to tone

DH3: Contradiction

DH4 Counterargument

DH5: Refutation

DH6: Refuting the central point

Our polarised political debate means Obama’s civility stands out. Perhaps we can restore civility and try to engage in what people are saying and why, rather than who they are and how they say it?

Twitter: It’s not you, it’s me

TwitterDying
Image via A Gentleman’s Journal

There I was, about to write another post on why I’m not as enamoured with Twitter as I once was (I have previous on this). The latest addition would have been prompted by this post on why Twitter still isn’t a social network, and particularly this bit:

[U]nless you’re a power user, someone sharing a unique story or a chance witness to something big, Twitter is essentially a broadcast you’re viewing[.]

But then Paul Clarke wrote a characteristically insightful and honest piece about Twitter. He notes:

[I]f you wanted to keep Twitter fresh for you, you needed to work at it.

And what did we do?

[W]e didn’t.

Dagnammit, he’s right.

For the last two years, it’s me who hasn’t put in the effort I used to with Twitter. The disappointment I have when my timeline isn’t what I want it to be is reminiscent of how I feel when I only get bills through my letterbox or promotional emails in my inbox. But there’s a reason that happens, too: I don’t send letters and only get personal emails if I’ve sent one myself.

So, you see, Twitter – it isn’t you, it’s me.

The issue I now face is that the only time someone says this is when they’re about to break up.

Thymos: the desire for recognition

Plato Chariot

The division of the soul between desire and reason was familiar to me. What wasn’t familiar is the tripartite division of the soul, between desire, reason and what is called thymos: the desire for recognition.

The implications of thymos are considerable. In fact, Hegel argued it is the desire and so struggle for recognition which is the driving force of history.

We can see this in at least three ways.

The first is to understand thymos as our sense of justice. By believing we have a certain worth then we create the possibility for a sense of injustice if that worth isn’t recognised by others. In situations of injustice we can sometimes become angry or indignant – the latter’s etymology explicitly linking our reaction to its impact on our dignity.

The second is to see that, in a world of comfort and where most material needs are met, it is the thymotic part of the soul that is capable of driving action. If we were truly satisfied – the drives of our desires and our reason are met – then we would have no requirement to struggle. But when we feel our own worth or that of others not being recognised we seek out further struggle.

The final one is to recognise that the political process, our democracy, isn’t just about the process of using evidence, making decisions and balancing the competing interests of groups for the greater good. Democracy is also a platform through which people seek recognition for themselves and their views – it is driven by thymos.

Our conception of thymos isn’t singular. One person’s desire for recognition could be the desire to recognised as superior to other people (known as megalothymia; think Donald Trump). But the force of isothymia – the desire to be recognised as equal to other people (think of every rights-based movement) – is one that appeals.

Let us recognise, then, that people seek not just to satisfy their desires or act with reason to maximise benefits to them; they also act through thymos: the desire to be recognised.

Interest groups and political polarisation: outside the Bell Curve

There is a great passage in Francis Fukuyama’s Political Order and Political Decay (pp.481-484) that reminded me of what we’ve talked about here before: the exaggerated nature of political debate.

To summarise our thoughts (in the context of public services):

  • People’s experiences of public services follow a Normal Distribution
  • Although most people’s experiences are average or thereabouts, the experiences and examples we hear most about are, almost by definition, unusual
  • Politicians, organisations (from whatever sector) and the media most often talk about the very best or the very worst that public services have to offer
  • The very rare is what drives most activity in public services.

It’s this difference between the ends and the middle of the Normal Distribution that creates the problem in the space of people’s expectations of public services: The gap between what the Normal Distribution says our experience is most likely to be (95% of people will get an average service) and what we think our experience will be – the space represented by newspaper headlines and political rhetoric – leads to expectations that, in reality, can very rarely be met.

Normal Distribution - public services

Fukuyama’s example relates to interest groups within the political economy, and it is a compelling explanation of why our political debate feels so polarised (in the equivalent way to why feelings about our public services are so polarised).

By way of background, Fukuyama first notes Mancur Olson’s negative portrayal of interest groups, in which Olson feels they operate only to extract benefits for themselves. This itself would be fine, except for the fact the general public can’t organise as effectively as relatively small interest groups, resulting in a “steady diversion of energy” into activities that only benefit the interest groups.

Fukuyama then summarises de Tocqueville’s more positive take on interest groups, in which it’s argued they are “schools for democracy” and teach private individuals the skills of coming together for public purposes.

Somewhere between the two is James Madison, whose view of interest groups was that, even if you don’t agree with the ends a particular interesting group is after, the fact there are so many of them would prevent any one group from dominating. Echoing how a free market operates, this pluralist approach to interest groups means they’d all interact to produce an overall good for the public.

What, though, is the reality? Fukuyama comes to the same conclusion we do about the exaggerated nature of public policy – interest groups polarise politics.

Sharks Jets
Image via Fanpop

Fukuyama gets to this conclusion by drawing on arguments from E.E. Scattschneider and Olson as follows:

  • Political outcomes rarely follow from political preferences. Because there’s generally a low level of political awareness and participation amongst the population as a whole, decisions are actually taken by smaller groups of organised interests
  • What compounds this is that not all interest groups are equally capable of organising themselves
  • Those that are capable of organising are much more motivated to do so: they may feel more strongly or have more clearly defined positions they need to “defend” compared to weakly-held views or less well-defined positions
  • As a result, “politics is defined by well-organised activists, whether in parties or government, the media, or lobbying and interest groups” and there is an “intrinsic overrepresentation of narrow interests”
  • As a result we do not get compromise positions; instead we have polarisation and deadlocked politics.

It’s this that leads to the nonsense we see on Question Time each week, or “debates” where a presenter simply pits one viewpoint’s representative against another’s. It’s frustrating, and actually not at all representative of what the vast majority of people think.

Whilst political debate therefore operates mainly in these exaggerated positions at the margins, so it will be that people will disengage because of the seeming irrelevance of the debates to people’s everyday thoughts and beliefs.

Always carrying a notebook

DV notebook
One of da Vinci’s notebooks. Source: The Leonardo Project

A good friend at university used to have a pen in their pocket all the time. We called it Wrighty’s Indie Pen, our sentiment a mixture of bemusement, disparagement and admiration.

Only in the last 18 months have I understood that Wrighty was on to something. In that time, I have carried an A6 notebook and pen in my pocket at all times and it has been fantastic. The notebooks have all sorts in them – thoughts, reminders, work, useful numbers, sketches, lists etc. – and I can’t now see a time when I wouldn’t have one in my pocket.

I mention this because of reading 9 things that happen when you carry a sketchbook with you nonstop. From there, it is a short hop to the positive difference carrying a notebook can make and the unanswerable question of which style notebook to use.

There is then the matter of how others have used their notebooks – here are 20 famous examples (I don’t know why they’re all men’s notebooks).

It’s a different experience entirely to making notes on your phone/tablet or carrying a more formal notebook of, say, A5 or A4 size. I commend the notebook to you.

The opportunity for public services of truly engaged expert citizens

The World Wide Web was invented in 1989 and Google was incorporated as a company nearly a decade later, in 1998. AirBnB started in 2007 and Uber in 2009.

I wonder why there was such a big delay between the web and Google, and then Google and AirBnB, Uber etc., and then a subsequent delay in their reaching a tipping point in terms of awareness and use by the general public?

I ask this because there have been a very wide number of approaches and initiatives for improving public services, not least health and social care, through technology and particularly the web. For example, there have been care comparison sites a-plenty, much talk of open data and suggestions of location-based services to replace off- and online directories. And yet we see relatively little evidence of these approaching a tipping point, let alone being used regularly by local authorities, providers and the general public when it comes to health and social care.

The prompt for these thoughts is this excellent, detailed post at Policy Exchange about the rise of the citizen expert.

In it Beth Simone Noveck (former United States deputy chief technology officer and director of the White House Open Government Initiative) takes as a starting point another area of public policy – citizen engagement – and notes how the obvious opportunity to improve public services and local communities hasn’t been taken in the way it could have been.

Citizen engagement isn’t just the equivalent of technology: it’s clearly bigger than that. Beth makes clear this point by showing how better harnessing the interests and expertise of citizens can help both bridge the democratic divide and make the most of people in contributing to their local communities and society.

The internet is radically decreasing the costs of identifying diverse forms of expertise so that the person who has taken courses on an online learning platform can showcase those credentials with a searchable digital badge. The person who has answered thousands of questions on a question-and-answer website can demonstrate their practical ability and willingness to help. Ratings by other users further attest to the usefulness of their contributions. In short, it is becoming possible to discover what people know and can do in ever more finely tuned ways and match people to opportunities to participate that speak to their talents.

But she also notes the most significant barrier to this: the continued dominance / monopoly of policy- and service-elites in the work that they do:

[There is a] long-held belief, even among reformers, that only professional public servants or credentialed elites possess the requisite abilities to govern in a complex society.

Why? Because it is believed

Citizens are spectators who can express opinions but cognitive incapacity, laziness or simply the complexity of modern society limit participation to asking people what they feel by means of elections, opinion polls, or social media.

The shifting of the cause of the problem of a lack of engagement onto citizens themselves rather than the professionals asking the questions is a familiar refrain. We regularly hear laments about “the usual suspects”, limited response rates or adversarial consultation processes that create more problems than they solve.

But this characterisation of this situation only makes sense for one set of players: it suits both the technocratic elites who dominate public policy and services, and the other well-embedded elites with (vested) interests who can mobilise quickly to respond to consultation/engagement that affect their organisations.

It is, of course, a characterisation that doesn’t really stand up to scrutiny. For example, we know that (proper) co-production in health and social care has a solid evidence base in the difference it makes. But we also know it continues to be at best a nice-to-have rather than a must-have.

Thus we come back to the questions kicking about in my mind at the start of this post: if the ability to do this sort of thing exists (be it citizen engagement or technology), why hasn’t social care and the like made the most of this opportunity?

It’s largely because elites aren’t yet comfortable with distributing leadership and expertise.

One of the ways to overcome this discomfort, then, is to make it valuable and rational for the existing elites to engage in effective citizen engagement by ensuring a ‘good’ group of people are engaged and involved in public service reform in the first place.

Noveck rightly says:

To make all forms of engagement more effective, we need to increase the likelihood that the opportunity to participate will be known to those who need to participate. If a city really wants to improve the chances of crafting a workable plan for bike lanes, it should be able to reach out to urban planners, transportation engineers, cyclists, and cab drivers and offer them ways to participate meaningfully. When a public organisation needs hands on help from techies to build better websites or data crunching from data scientists, it needs to be able to connect.

To do this:

[I]nstitutions [must] begin to leverage such platforms to match the need for expertise to the demand for it and, in the process, increase engagement becoming more effective and more legitimate.

This is appealing. Citizen engagement may not be valued by elites because there hasn’t been adequate effort or ability to engage sufficient citizens to make it worthwhile enough.

As Noveck concludes:

This is about chances for civic participation; to be a member of a local community and to make a contribution based on this… It has everything to do with what it means to be a citizen in a contemporary democracy.

This is why I particularly like this: this isn’t just about technical changes around the edges of public service economies, but the broad meaningful difference it could make.

 

Public services: only a means to living full and active lives

GYA

I’m involved with the Get Yourself Active campaign and recently wrote a blogpost for it, which is reproduced below. There’s also a fantastic post by Anne Beales of Together UK (on small steps and grand plans) and from Leanne Wightman (who is doing a great job of running the whole project) on the opportunity of Get Yourself Active. You can follow Get Yourself Active via @GetYrselfActive

There were some headlines recently about how people were using their Personal Health Budgets. Concerns were raised about whether items like games consoles, a summer house and satnavs were the best use of public money, with the inevitable calls for resources instead to be focused on traditional ways of doing things – beds, staff, medical equipment.

A positive aspect of the debate was it provided an opportunity for people who have Personal Health Budgets and the professionals who support them to explain why they’re so important in meeting their care and support needs. Kevin Shergold, for example, highlighted:

The PHB has given us freedom to live our lives as we choose – in a way that’s sensible and cost effective. Developing a severe disability might seem hopeless, but I want people to know that it’s possible to live a good, full, interesting life when you have the right support and choice.

This gets to what I think is a vital but often unasked question: what is the point of public services and so the money that funds them?

The vast majority of people with lived experience and who have used care and support services say that they want a life, not a service. Their focus isn’t on getting a few more hours of home care here or seeing an occupational therapist there; it’s about living as full and enriching a life as possible.

Norman Kirk – a New Zealand Prime Minister in the 1970s – described it this way:

People don’t want much. They just want someone to love, somewhere to live, somewhere to work and something to hope for.

He could well have added “something to do”, because wanting to be physically active or play sport is often reported by all people, including disabled people, as a key source of general wellbeing.

The point of public services and the money that funds them, therefore, covers being a means to support wellbeing and achieve what people want to do in their lives – including being active and playing sport. We have already heard from a number of people through the Get Yourself Active project that using their personal budget in this way has changed things for the better.

This means there are three main reasons why I feel Get Yourself Active is such an important contribution:

  1.  It helps to support people who use care and support services and the professionals who work in them to recognise the value of physical activity and sport
  2.  It provides a much-needed wider focus on how Personal Budgets can be used to directly support such activity, and not just focus on traditional ways of meeting people’s needs
  3. And, by the way, it helps councils and their partners meet the general wellbeing requirements of the Care Act.

If this leads to more stories about how Personal Budgets are being used to fund exercise classes, gym memberships or being involved sporting activity, I for one won’t be disappointed. It will mean that public services are doing their job well.