This much we know

We know that we need prevention not crisis response – but that commissioners will not invest consistently in prevention, however much we want them to.

We know we need workers to act autonomously and take risks in the individual’s best interests – but that most large organisations will create systems which rule this out (because risks to organisations invariably trump the risks most important to individuals).

We know we need people to see themselves as sharing responsibility for their own health and wellbeing – but that the majority of professionals will feel they should look after the people ‘in their care’, and will risk criticism if they don’t.

We know that the most effective interactions are those we have with people we have had time to get to know, which can only ever be a small number – but that planners will always seek to work at the largest possible scale and see contact time as a reducible unit cost.

We know that to do the right thing consistently, we all need to act as if we are group of humans, but that we all act like we are the subjects of an all-powerful system.

In fact, there’s no such thing as the system: there’s only us and the relationships we have. So we don’t need to – and can’t – try to change the system. Instead we need different relationships with our peers and new relationships with people we haven’t previously thought of as our peers.

Here are four things I think we can do if we’re serious about radical change:

Shift power in the form of money: through handing control of money wherever possible to individuals and small groups, and spend money currently spent on procurement giving them the support they need to spend it creatively.

Shift power in the form of knowledge: through collecting data about the outcomes which matter most to local people and making it available to them in usable ways.

Shift power in the form of accountability. If now we feel accountable first and foremost to inspectors and finance managers, instead we need to ensure we account for ourselves regularly to groups of people who use services and other taxpayers, face to face.

If we do these things, we might just create spaces in our public services for the emotions which make the most difference: empathy, compassion, love.