Humanising Public Services

25 October 2018

Humanising Public Services

Traverse's Sue Goss gives her thoughts on the implications of dehumanising public services...

While the defence of the EU during the referendum campaign was all about statistics, economic assessments and expert opinions, the critique was crude: “a Europe of the bosses”. “a vanity project”, “just all restrictions and rules” – and behind it a connection to powerlessness; a loss of identity; a grand economic project that was ‘not for us’. We weren’t being listened to. We didn’t count.

Small wonder then, that this resonated strongly with people whose daily experience of trying to get by is beset by restrictions and rules, feeling powerless, not counting. For many, this experience comes not through their encounters with capitalism – which can seem to offer a fraudulently egalitarian access to fast food, cheap thrills and quick fixes - but from the struggle for benefits or public services.  

How did we get to here?

The original intention of the welfare state was benign, welcoming to all, care “from cradle to grave.” But by the end of the 70’s public services were widely seen as inefficient, subject to producer capture, unresponsive. The Thatcher and Major governments privatised where they could. Starved of funds, public services were no longer presented as for everyone – they were residual, for the losers. And while only the rich could exit from state education and health, the egalitarian assumptions underpinning public services began to break down.

The Labour governments between 1997 and 2010 substantially increased public spending, arguing that for the public to support this increase, services had to become not just efficient, but more effective. Along with the new funding came regimes of measurement and evaluation. Individual professional judgement was supplanted by compliance systems. Inspectors, consultants and central units monitored progress. The results are not all bad – services are more professional, more consistent. But in the process, we have lost something that matters more than any of this. We have lost humanity.

A state for keeping people out?

From 2010, as we, as a society, have become harder, less generous, less interested in equality, the state has become more and more about keeping people out. To belong to the narrow tribe of ‘hard working families’ we have to stand on our own two feet. Instead of wanting to share good fortune, and use resources collaboratively, we are encouraged to feel cheated if our taxes go to help others.

In the process, people working in public services have become gate-keepers, assessing ‘need’ against strict criteria –  every year, as the money is cut further, the criteria tighten, and more and more people are excluded. Instead of professionals using their judgement to listen, and help, they are over-whelmed with form filling. Further cost-cutting measures further dehumanise the experience of public services. On-line only services work for the young and skilled, but are hopelessly confusing and unresponsive for the homeless, the mentally ill, the elderly, people with dementia.

As the system tightens, as the money runs out, the scope for generosity dies and the system becomes overbearing, harsh, cruel. Services are withdrawn through a pitiless process of assessment. Vulnerable people are caught up in a nightmare reality of ‘computer says no’.  As public resources shrink, the poor turn against the poorest in a struggle for what’s left. No wonder recent immigrant communities are among those keen to restrict migration.

To empower others, we must be empowered

At the heart of the shift, is the removal of the human relationship between the care giver and the cared for. Public service workers no longer experience the freedom to teach, to nurse, to help – using their full human understanding and their professional skills. Staff who are treated as a cog in a machine become sick, literally. Worse, if the machine you are working in is inhuman in its responses, the only way to survive is to shut that part of you down – so that you don’t see it. We are not only dehumanising the receivers of care – we are dehumanising the care givers.

More state provision?

In our rushed, grudging, calculating public services, people who depend on the state are consigned to a loveless, stressful and lonely life. Who will hold their hand or make them laugh? We need more investment in public services, but we also need different public services. Churchill said that you can judge a society by the way it treats prisoners. We are defined by the way our state treats those at its mercy - the old, the frail, children, down-and-outs, the disabled, homeless, mentally and physically ill.

It is in what Habermas called the ‘lifeworld’ – family, friends, community – that we share love, laughter, a kindly touch, a listening ear. In community, and in family, we can be attentive to unspoken needs, and offer more than is asked for. We don’t for example, treat all our children the same. They need different things, so we try to help each to find what they need.

It can be exhausting to help yourself, or help others. But it can also be exhilarating, life-changing, to contribute, to take part, to take control. Government, especially local government, has a crucial role -stepping in to relieve the burden when people can’t cope and providing the necessary resources. The state can arbitrate between competing claims, prevent abuse, guard against fraud. But it can also slow down, dispirit and disempower us. The voluntary sector is often better at innovating, challenging, listening. Which is why it is so stupid to argue that one is better than the other, that public services are more ‘socialist’ than voluntary or community provision – or vice versa. We need both. We need a vibrant, active civil society and a strong, empathetic, creative public sector.

What should we do?

  • Invest in public services. Of course. Raise benefits. Increase spending on social care. Stop seeing the most vulnerable as a burden
  • Change the balance between what we spend on actual services – and what we spend on assessment, regulation, inspection.
  • Reframe public services as for everyone. Start welcoming people in.
  • Stop pitting state provision against voluntary and community activity.
  • Challenge the cultures of ‘assessment’ and ‘entitlement’.
  • Stop blaming the professionals when things go wrong. Terrible things happen. Instead create a culture of curiosity. Encourage bravery and challenge.
  • Empower staff. Enable them to bring their whole human ingenuity to work. Reduce case-loads. Give them space to treat every encounter as an opportunity to learn and change.
  • Change the training for public servants. Encourage open discussions about what sort of society are we trying to create. Reconnect with their humanity and what made them choose public service.
  • Recognise the contribution that we all make to society. Value it. Make it easier. Use the resources of the public sector to shore up and support community effort, not to exploit or undermine it.  

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