In the last years of Gordon Brown’s premiership, Swindon council embarked on a bold experiment. It asked Hilary Cottam, a celebrated young social entrepreneur, to find a new way of dealing with what the state was then calling “chaotic families” (later to be repackaged as “troubled families” under the coalition). What could Cottam do for those such as struggling mother Ella and her family, who lived in “roiling turmoil” in one of the large postwar estates on the edge of the town, with up to 73 professionals involved in their lives at an estimated annual cost to the state of £250,000?
Cottam, once described as being “to social design what Conran is to sofa design”, takes a deceptively simple approach. Instead of trying to contain ongoing chaos or impose unrealistic but unbending targets for improvement, she and her team set up base on one of the estates and began with dialogue, asking the families what changes they would like in their lives to see how they could be helped to turn things around.
The Swindon experiment, known as Life, had tangible results. Slowly, Ella’s family got back on track: work was found, family relationships improved, the teenagers began to attend school again. There were no overnight miracles or amazing transformations (no one ended up at Oxbridge) but progress was positive and sustained and all at a fraction of the cost of existing services.
Cottam describes four other similar experiments in equally engaging fashion. One project, Loops, supports young people in London to take their first tentative steps into employment; Wellogram helps people take control of their own health; Backr works with benefit claimants; while Circle functions as “part social club, part concierge service and part co-operative self-help group” for older citizens. Not every experiment succeeds – Loops founders early on over safeguarding issues – and there is often deep resistance from existing health and social service professionals, but Cottam and her team stick gamely to their founding principles. “I have learnt that when people feel supported by strong relationships, change happens,” she writes. “And when we design new systems that make this sort of collaboration and connection feel simple and easy, people want to join in.”
The book is packed with moving vignettes, such as the story of Stan, a partially immobile pensioner with a passionate love of music. “Why could Stan not ‘meet up’ on the phone, with others who share his love of music?” Tuesday becomes Stan’s music night, when he dials up other local residents and they play chosen pieces down the phone. One evening, after listening to Frank Sinatra’s “Strangers in the Night”, everyone bursts into a rendition of “Happy Birthday”. It’s Stan’s 90th. “Stan, who had not spoken to anyone else that day, beamed from behind his white hedge of a beard.”
Human stories are the beating heart of Radical Help, yet Cottam has a far bigger argument to make about our “moribund” and costly welfare state, designed for a postwar, mid-20th century world but no longer fit for purpose. William Beveridge presumed on women’s unpaid work to keep the domestic sphere going, but with longer life spans and so many women torn between the demands of care and earning, we now have an adult social care crisis.
Similarly, most modern diseases are chronic; they can’t be cured, they have to be managed (someone is diagnosed with diabetes every two seconds). Most of us can expect to have 11 jobs through our working lifetime: by 2020 half of us will be self-employed. Growing inequality has spawned new, seemingly intractable forms of poverty. At the same time, the harsh theories of New Public Management plus austerity have transformed the state into a dehumanised, demanding machine: obsessed with data and targets, forever measuring the activities of its staff and its “clients”.
Cottam, drawing on a long history of co-operative and grass-roots feminist thinking and practice, is much more concerned with fostering capabilities, making local connections and “above all, relationships”. “The welfare state might still catch us when we fall, but it cannot help us take flight.”
Small-scale experiments are one thing. The challenge, of course, is how to transform the workings of vast hierarchical welfare and health systems obsessed with “getting results”. Cottam is adamant: it’s not a question of “scaling up” her local projects but rather of getting similar experiments going all over the country, using digital platforms and design creativity to encourage and connect disparate, self-generating groups. (The book even ends with a tempting invitation for readers to start their own local schemes.) Those in charge need to learn to let go so that people can rediscover their intrinsic motivation and ingenuity.
There are some wry descriptions of meetings with politicians – including David Cameron – who initially lap up Cottam’s ideas but too often try to repackage them into more standard welfare or health proposals that drain the human richness and meaning from the projects. It is no surprise that some of the experiments have been taken up enthusiastically by Tories wishing to implement small policy “nudges” and looking for Big Society rationalisations for dramatically reduced spending. However, they have also struck a chord with a new generation of Blue Labour politicians who want to see the state move beyond being a nationalising big spender and act instead as a mediator of large-scale cultural change.
Cottam is critical of those who simply want to pump more cash into what she sees as a failing welfare state, but there’s a parallel danger that her rich, ground-up work will be employed in the service of the small state. By the end, I became interested in how her approach might work in the context of a more radical political and fiscal strategy, a blending of Blue and Red Labour. She is definitely on to something exciting in her insistence on the potential of both relationships and new technology to promote and sustain long-term human prospering. With a government prepared to invest in a radically modernised welfare state, Cottam’s ideas could help transform the way we all live. If it hasn’t done so already, I hope that the Labour front bench will call her in.
Melissa Benn’s latest book, “Life Lessons: the Case for a National Education Service”, will be published by Verso in September
Radical Help: How We Can Remake the Relationships Between Us and Revolutionise the Welfare State
Hilary Cottam
Virago, 320pp, £16.99
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This article appears in the 06 Jun 2018 issue of the New Statesman, The Nuclear Family