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It’s a constant challenge to shift power from one person to another, even if both are willing. Don’t fool yourself into thinking you are powerless.
The nature of the problems the welfare state is trying to solve have changed. That’s why we need to build a 21st century welfare state that puts people and relationships at its heart.
Governments sometimes have the propensity to politely applaud grassroots movements from the sidelines instead of harnessing their power – and some are even seen as a threat. Here’s the view from Finland on NHS Change Day, citizen activism, and hope.
It’s hard to change the way you do things, whether it’s within a family or a government department – money, risk and anxiety can stop us from trying something new. But we’re starting to see some real breakthroughs in local community work. How can we help that hope to spread?
Say what you will about the UK drinking culture, but if you want to cut down on your intake, it can often feel a bit… lonely. It’s easy to lose hope without a group of people to support you – but that’s just what Club Soda is. Here’s co-founders Laura Willoughby MBE and Dr Jussi Tolvi on why relationships matter when you’re trying to make a change.
Every year, hundreds of thousands of people express their strong desire to do things differently in health services. Why don’t we take them more seriously?
By Kate Bagley, Campaigns and Content Manager
Two months ago, we were sitting around a table full of clever young social innovators from Finland, when the subject of NHS Change Day arose. They were trying to start something similar in their own country, and asked what we thought of it. And honestly, I wasn’t sure what to tell them.
As a digital communications person, I have a tremendous amount of respect for the campaign. It’s great at bringing people together online and recording their collective desire to do things differently. This year, they’ve shifted the emphasis from ‘pledges’ to ‘actions’, and as of right now they’ve collected loads of inspiring stories. There are clearly thousands of motivated, caring people working to make a difference.
But as someone who uses the NHS regularly – and I really hesitate to say this because I love that Change Day exists – I can’t say that I’ve seen any major changes happening. The NHS does not seem to have been fundamentally changed by Change Day. But the grassroots support is obviously there. So what’s going on here?
I couldn’t sort out my feelings about it, so I got in touch with online mental health activist Mark Brown. He’s had a lot more personal experience working on making change happen in health services, and kindly provided some much-needed perspective.
One thing we both agreed on that goes part of the way to explaining it: change is hard! It can take a long time for these types of grassroots efforts to make an impact, especially on something as complex as systems change. But that’s just the beginning of an answer.
Another thing Mark pointed out that really resonated with me is that a lot of the focus of NHS Change Day is on individual actions and qualities, with the assumption that enough of these will add up to a changed institution. In reality, that’s asking a lot. As we’ve said before, even the best behaviour modelled by frontline workers needs support from above to be sustainable. Right now, we’re asking individual people to pick an action which they think will help deliver better services – in the face of still having to hit certain time and delivery targets, not antagonising coworkers, and breaking down biases built up by having to support people in their very worst moments, day after day. Even if they pick something great, how long can they keep it up? How much impact will it have on the system as a whole?
If we took the hundreds of thousands of people who want to change the NHS more seriously, we would be giving them the tools and support to be able to make a much bigger impact. Give people the time, resources, encouragement, and skills to work differently. That sounds easier said than done, and it is. But if we were to invest more in prevention and non-patronising forms of social support, we’d have more room for innovation. Mark wondered if maybe “NHS Problem Setting Day” might not be more effective. There’s something to be said for that too – taking a step back to get at the root of the problem before trying out solutions is an essential part of our design process at Participle. Few people understand the systemic problems in the NHS better than the people that work there, but we don’t give them a moment’s time (much less a whole day) to step back and consider what’s causing those problems.
Of course, I didn’t have any of this sorted out when our Finnish visitors asked what I thought of NHS Change Day. So I told them what I really thought in the moment, and what I think still stands: The best thing to come out of NHS Change Day is hope for the future. It’s a show that we know things aren’t working the way we want them too, but we love and believe in this institution and we’re committed to figuring it out. There’s hope that we’ll be able to reach everybody that needs help, everyone that needs the health service in the course of their life. And hope that we can reach the people who can help us, the people who have the power to say, “You’re right. This isn’t working. Let’s commit to doing things differently – all of us, together.”
Our Finnish friends promised to report back on what happened, which we’ll share with you as soon as we hear. I hope they’ve had a lot of success, and I’ll be interested to see what they learned. There are so many great ideas among the sea of pledges and actions recorded. I hope some of them will get the support they deserve.
Thanks to Mark Brown for his time and thoughts on this issue. His latest project is A Day In the Life, a library of personal stories which collectively show what it’s like to be a person with mental health difficulties in England in the 21st Century. Find him online at @Markoneinfour.
Image by Ewan Munroe, via the Flickr Creative Commons.