I’ve never accepted an invitation to speak at an event abroad during my time with Shared Lives. The opportunity to learn something completely new is tempting, not to mention the chance of seeing another country, but usually the bill would fall upon Shared Lives Plus and the cost plus the time can seem hard to justify when there’s so much to do in the UK. So it was a real pleasure to receive an invitation from the British Council in Finland to speak at an event on public service reform in Helsinki, not least because they were willing to fund and organise all the travel arrangements as part of their mission to foster shared learning between the two countries. I’m writing this on the plane home, wishing I’d had more than a one night whistle-stop tour, but the event was sandwiched between a meeting with Care Minister Norman Lamb on Wednesday and the first meeting of the White Paper Implementation Board the next morning.
Helsinki in late November was just having its first proper snowfall. We walked to the event at the British Embassy in semi-darkness just before 9am, past a gaggle of nursery children in bright orange vests, playing happily on a playground in the gloom and horizontal snow. It was about -2°C. I didn’t notice how long daylight lasted, but it was dark again by mid-afternoon when I left. The garden of the Ambassador’s residence was under a blanket of snow and host to the kind of squirrels you can’t find in Britain any more, with cute tufty ears. Naturally I expected Ferrero Rocher, but these are straitened times.
Sometimes it’s the small things which give you a sense of how different another country’s culture is. Finland was described by my Finnish host as a very ordered and rule-abiding country, where some of our ideas about social enterprise or individual choice and control would be viewed with scepticism. In the UK we sometimes think of ourselves as being overly hidebound by red tape, slavishly following EU procurement rules which we imagine other European countries are ignoring. The Finns aren’t ignoring them – they see them as a barrier to the development of social enterprise approaches to delivering public services, for instance. The rule-abiding Finnish nature was brought home to me at a pedestrian crossing in Helsinki. About 20 people were waiting for the green man when the (tiny amounts of) traffic moved on and the long straight road was obviously clear for some distance. As I would have at home, I immediately hurried across the road and was startled to find myself crossing alone with 20 pairs of eyes on my back. The Finns were still waiting for the green man even though it was safe to cross. Perhaps this also reflected a less frantic approach to the pace of life, but I suspect I committed some kind of jay-walking offence.
Because neither Finland’s public services nor its spending budgets appear to be feeling the same level of crisis that we are facing in the UK, the pace of change there is likely to be slower and circumspect. So I didn’t come home with lots of examples of different ways of doing things, apart from hearing about the benefits of a genuinely integrated health and social care system, which I wish we could emulate in the UK.
What I did find thought-provoking though, was talking with people working in a public services system born out of a society in which equality is highly prized, whereas the concept of ‘fairness’ is less familiar. This isn’t to say that things are unfair in Finland. But with public consent for higher taxation in return for a more comprehensive welfare state, equality is something which Finns believe their government can and should deliver, so fairness is less relevant than it is in the UK, where equality is not obviously achievable and regarded as constrictive or as ‘dumbing down’ by some.
In childcare for instance, free provision seems to be more universal and of high quality, so would it be sensible to introduce more choice? Choice always involves an element of competition, not just between providers, but often between people who use services. In theory, I can choose my kids’ school. In practice, it feels like the ‘best’ schools get to decide whether to choose us, unless we can afford to move closer to them and thus use wealth to out-compete other parents. Less sort after schools can further decline as the middle-class parents take their money, high levels of aspiration and social capital elsewhere, which can increase inequality, even though the element of choice gives an impression of ‘fair play’.
The case for introducing choice seemed clearer in older people’s services in Finland, where despite a more comprehensive free offer, elements of some services were poor. At a deeper level, talking to people living in a more equal society made me question my growing belief that all services carry risks of undermining social action and informal support relationships. This appears to be as true of Finnish services as UK ones, but with more resources, is that as damaging in the Finnish context as in the UK, or could Finland’s society afford to risk some of its potential social capital in continuing to provide more comprehensive services, and perhaps reap benefits as a result, such as people being less likely to need to give up employment to become family carers?
You may have read me quote John McKnight in this blog before, suggesting that services tend to inadvertently colonise communities, displacing their native relationships and social capital with less effective and unsustainably expensive professional/client interactions. I wonder if McKnight would have held such strong views on this if he’d been writing in Finland in the 90s, rather than in the US at that time?
I won’t be spending huge amounts of time globetrotting (sadly!) but I hope that some of what I had to say was of interest or challenge to my Finnish colleagues and I felt that, even if you don’t come home laden with ideas for new interventions, the opportunity to test your beliefs about innovation and service reform in a completely different environment was a worthwhile use of the day. And one belief I came home with stronger than ever, was that many of the problems we grapple with would be much easier to fix in a more equal society.
Interesting observations that got me reflecting.
I think that it is a real challenge for services and workers who have become used to being expert providers of services to stand back first and look at the assets in communities and in people and to complement what is going on rather than do things for people. I know I am finding it tricky to take an asset based approach to my work – I believe in it and being rooted in advocacy you’d think it would be second nature. The thing is it requires more time and an openness to uncertainty and some positive risk taking and a bit of a culture change. (easy then!)
I hope the current climate here in the UK will lead talented people in services having the opportunity to take more creative approaches to working with people in communities. Workers often leave public service to go off and pursue their own interests / downsize. Wouldn’t it be great if future job specs encouraged people to demonstrate their strengths and interests and how they envisage investing them into the workplace and local communities?
A lighter more sustainable touch is required which involves focussing on developing age-friendly communities and cities which happen to have age friendly services.
‘Genuinely integrated health and social care system’ – I can see the attractions of that in terms of budgeting and efficiency, especially for older people, but in such an integrated system how do you preserve the non-medical, social model, independent living aspects of good self-directed social care support? As a younger disabled person I’m concerned that integration of social care with health could re-introduce the medicalisation of disability to the detriment of proper independent living.