Opinion: Public services need public involvement

arrest in chicagoI must admit, I have become sceptical about the word ‘empowerment’.  For two reasons.  One is that it is a Blairite word, and based on a misunderstanding about where sovereignty lies.  Power isn’t distributed by an all-powerful prime minister. People already have it – they give it to the governments – but sometimes they have to be encouraged, persuaded or cajoled to use it.

The other reason I have become sceptical is my experience of the word.  I have sat in too many conferences where disabled people are encouraged to say how grateful they are for being ‘empowered’, while their satisfied care managers clap.

No, we need to acknowledge that, for a range of reasons – including budgetary – all that talk of empowerment has resulted in very little real power shifting.  The empowerment agenda has not borne fruit.

Why not?  My new report for CentreForum, Turbo-charging volunteering, tries to apply the American co-production critique to UK services – and that suggests that service users will shift power in the system unless they are playing and equal role helping to deliver services alongside professionals.

The term co-production was coined by the Nobel prizewinner Elinor Ostrom.  She was asked by the Chicago police to find out why, when they took their police off the beat and into patrol cars – and gave them a whole range of hi-tech equipment that can help them cover a larger area more effectively – the crime rate went up?

This isn’t just a question confined to the police.  It lies at the heart of why public services become less effective on the ground as they become less personal and more centralised.  Elinor Ostrom’s team decided that the reason was because that all-important link with the public was broken.

When the police were in their cars, the public seemed to feel that their intelligence, support, and help were no longer needed.  She called this joint endeavour that lies at the heart of all professional work coproduction.

No amount of empowerment rhetoric made any difference.  The shift happens when doctors realise how much they need patients, and teachers need pupils, and politicians need the public – if they are going to succeed.

 

* David Boyle is a former Lib Dem parliamentary candidate and the author of Tickbox (Little, Brown). You can buy the book from Hive or Amazon.

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8 Comments

  • Although I find your arguments sound – surely some form of direct democracy is more likely to bring government and people closer together. The gap is so wide now that a fundamental shift is required so that the people feel they are living in a democracy, where government and its agencies are seen to be serving the people – rather than creating a dictatorship of the political class.

    Some appropriate form of DD seems the only certain way to achieve this.

  • I’ve thought this for years. People just need reminding that they employ politicians and are electing representatives not leaders..

  • Matt (Bristol) 23rd May '14 - 1:25pm

    Different sections of the public sector and charitable economy operate the ‘principle’ of co-production differently because they have different profeesional disciplines and models of engagement. Contrast how a social worker might in principle approach a service user / client to how a hospital consultant might approach a patient; one disipline is taught that it must ideally respect the client as the expert on their own needs, the other arguably has a built-in tendency to respect their own expertise first (for often good reasons).

    SOme public sector attempts to engage the service user by asking themm to fill in an awful lot of paperwork can be counter-productive, just as private sector ones are.

    But overall, I agree with the thrust of the post – the point is the public sector is working primarily towards differing outcomes than the private sector, and whilst techniques and structures based on maximising efficiency or ‘profit’ or target-hitting might be helpful to consider, if they do not take into account the fact that the primary aim of the organisation is not a money-terms profit but a benefit to the community, they are not going to be effective in the longterm.

  • Matt (Bristol) – the public sector may be working towards benefitting the community, but ultimately it suffers from the same constraint that the private sector operates under – fundamentaly it can only provide the service that its users are prepared to pay for.

    There is a massive disconnect in this country between what users quite reasonably expect from the NHS and what they are quite reasonably prepared to pay for. When you factor in the increased demand driven by an ageing population and ever more sophisticated treatments that disconnect will only get bigger.

    I don’t have an answer to this, but, much like pensions, at some point the nettle will need to be grasped.

  • Matt (Bristol) 23rd May '14 - 1:59pm

    Tabman, I work in a related sector to the NHS and I understand that point; there are no money trees; but Daivd is also right to say (if I understand him) that unless the end-user is engaged with the outcomes being sought, efficiency gains can effectively be lost as the unseen benefits of having the public working with you are replaced by drag factors.

  • Matt (Bristol) 23rd May '14 - 4:46pm

    David Beckett, what does your comment have to do with the thread?

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