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When Worlds Collide

8 May 2019 - 11:34 by karen.dyson

It is possible to switch off from work when you have a job in the voluntary sector but this hasn’t been one one of those days for me.

The day began with a tram journey to Manchester, whiling away the time as I often do, by pottering about on Facebook and twitter. Most days I think this just answers my own question about why don’t I read as many books as I used to, but today it was very productive. As well as excellent and inspiring stories about creative work our colleagues are doing in the sector and the benefits this brings for the people of Manchester, I also came across an interesting discussion about ethics in healthcare.

Now, ethics is something that interests me. I did a very weird degree which let me take a whole variety of courses across different faculties of my university, but a big chunk of it looked at ethics. The theory came from the philosophy department: what are our goals as human beings, where do ethics and morals come from, especially if you don’t believe in God, and what is happiness and is it ethical to strive for it? The sociology department took a more practical approach, looking at how people live together, particularly in cities, what strategies they adopt to help them get on with each other, and what our responsibilities are when these things don’t work for us. I don’t think these were billed as ethics topics, but they rang a lot of the same bells for me. I got another go at it when I did my PG Dip with the Open University, looking at the ethics around social research, and how university ethics committees make decisions about the type of research they will support their students to carry out.

The twitter discussion included some medical and clinical issues, such as who gets access to new drugs and what constitutes brain death, but the majority of the issues raised were around much broader issues such as how much influence do people have over decisions about their medical treatment, relationships between people with mental health issues, the health and the criminal justice systems, end of life care, and body autonomy. In short, a lot of the questions were essentially about who gets to decide what happens, what is a desirable outcome and how to help the person/patient get there?

In the evening I went to see Equus at the Lowry. I saw it before, several years ago, and it was the first thing that Daniel Radcliffe did after Harry Potter. It was stunningly good so this production had a lot to live up to. It didn’t disappoint. The acting was superb, and the conversations between the characters much more poignant than I had remembered. The play is about a teenager who has attacked several horses and blinded them. He’s brought to a psychiatric hospital and a psychiatrist who has to work with him to find out why he did it, and treat him but the discussions around that story were, again, all to do with who gets to decide. Who decides what is ‘normal,’ who decides what constitutes a good lifestyle – and what dreams, hopes, passions and context to his life will the boy lose if the psychiatrist succeeds in ‘fixing’ him? By committing a crime, has he given up all power and influence over anything that happens to him?

The link to work was thinking about who gets to decide what happens in our communities and neighbourhoods. Co-design and co-production are terms I’ve been hearing a lot since I came back to Macc. On the surface, these working methods are about sharing decision making power with the people who will be affected by the decisions, and so addressing power imbalances and increasing the amount of influence people have over their own lives and communities. However, I’ve also been to quite a few events that were billed as co-design and coproduction but weren’t, most strikingly a co-design group for a grants programme where the amount, purpose, eligibility criteria, application process, and monitoring requirements (which in my opinion were out of all proportion to the amount of the grants) had already been decided.

There’s the question of how far back you go or where in the process you start. In the example above, even if the rest was still up for debate, it had already been decided that there would be a grants programme – and not that the groups would automatically be given some money, or that they’d be given equipment or a consultant’s time, or any other option. Therefore the opportunities people had to genuinely influence were limited. I also don’t think I’ve ever seen an exercise like this that considers what happens when worlds collide – if the options selected by the group or community were something that the organising body thought of as bad or undesirable, or even things that would be damaging to the people concerned.

These aren’t new things. I worked for a government funded regeneration programme about 20 years ago now (how can I POSSIBLY be that old?!) where the main thing that local residents wanted to happen was the demolition of a row of scruffy shops that, in short, they felt lowered the tone of their neighbourhood. However, the shops weren’t derelict; businesses were running from them and families lived in the flats above them. As the regeneration programme was all about jobs and economic outcomes, the government office told us in no uncertain terms that we couldn’t use the money to make this happen. Even if we re-housed the families and found alternative business premises, the demolition of the shops to simply leave a cleared, open area, which is what the residents wanted, would mean the loss of jobs, the loss of business premises and a reduction in the economic viability of the area. So as far as the residents were concerned, they had no influence. The regeneration programme couldn’t do anything they wanted it to, so what was the point of it if they didn’t get to decide?

I also came across similar issues at Citizens Advice, particularly in my early days as a volunteer in one of the more affluent areas of Birmingham. Many of the volunteers were older, white women, disparagingly referred to by other local agencies as ‘the twinset and pearls brigade'. I witnessed a few falling outs between advisers and clients where, although the clients had been given accurate advice about benefits and housing entitlement, they perceived it as being told what to do by someone in power, who didn’t understand them and their lifestyles and didn’t empathise with the choices they had to make about their own lives.  They saw it as middle class, educated, privileged people laying down the law about what they could and couldn’t do in their own lives, based on a set of precepts about what was ‘good’ that they had no influence over.

In the example above, the ultimate rules for the regeneration scheme and the benefits system were set by the government and government agencies, by people that we elect to make decisions on our behalf, so arguably we still get to decide. However, increasingly people feel removed and remote from these national decision making bodies and disempowered by them - so decision making, voices and influence in local communities become even more important.


It's taken me a couple of days to write this, and in the meantime two more things have happened that got hung on the mental hooks these thought processes created.

The first was that I took my mum to the Dancehouse Theatre to see Stuart Maconie interview Paul Mason about his new book, Clear Bright Future. I’ve read articles and pieces by Paul Mason before, but I hadn’t read any of his books or heard him speak, and to be frank, I thought he was a dreadful speaker. For every sentence he finished, he started at least five others, constantly interrupting himself, so that by the time he got to the end of the sentence, it bore no relation to what he said at the beginning!  It was a 45 minute rant – the state is broken, the economy is broken, politics is broken and our big businesses and institutions are in danger of being broken because artificial intelligence and automation are taking over the world and shifting people from one set of low paid meaningless work to another. In so far as he offered any solutions (shoehorned into the last three nanoseconds) it was actually encouraging; bringing communities together to form powerful and influential bodies, supporting them to fight their own battles, neighbourhood action and crowdfunding, developing alternative transactions and currencies such as timebanks and social coins… in short, all the things the Policy and Influence team and my colleagues in Macc are working on right now! There was only about five minutes for questions and sure enough by the time I’d formulated what I wanted to ask, it was all over bar the book signing (I didn’t buy a copy – my mum said she’d order it from the library!).

However, then I went to Macc’s TED Talk Cinema Club last night, where I sat in the dark with a tub of popcorn and several Pirate-types from Manchester’s health and social care sector and watched Jeremy Heimans talk about What New Power Looks Like. He talked about many of the same things – creating new power and influence from participation, from doing things yourself, from not waiting for traditional power models to give you permission to make changes. Where he was less encouraging was in his answer to my lately-formulated question about how do you take these small, locally-based, positively-disruptive initiatives and scale them up successfully? He phrased this as ‘what happens when new power gets powerful?  How do you use institutional power without being institutionalised?’ His answer seemed to be that he wasn’t sure that you can; thus far new power movements have become part of the mainstream, and either been swallowed up by old-power institutions who see them as a threat (think Green and Blacks being taken over by Cadburys or Innocent Smoothies by Coca Cola), become things against which even newer new power starts to rebel, or found themselves having to side with, or espouse, old-power models and behaviours to stop these things happening (think the unionisation of Uber drivers.). His call to action was that new power should not be an island, and rather than tinkering around the edges of creating slightly better consumer experiences, it should harness its powers of mass participation and peer coordination to influence and tackle the great public goods.

So now we’ve come full circle back to who gets to decide what is good, and how do they influence others to think likewise – and indeed a lot of the post-popcorn discussion focussed on exactly these issues. We still didn’t come up with answers. How do you scale things up, and how do you stop them being shouted down or overwhelmed by existing patterns of working?  Maybe our systems leadership work offers the answer – it’s okay if the systems themselves change to embrace them rather than shutting them down because change is scary and they see it all as a threat (think the politicians’ response to Greta Thunberg this week!). The conversation is continuing on twitter, so if you have any thoughts on this, do share them!

Unfortunately, such a mentally stimulating week has not been conducive to a good night’s sleep. I ended up lying awake at 4am this morning mentally composing a song about insomnia to the tune of ‘Hallelujah’ – but that’s another story!

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