Lessons about place: #1
Definitions of place are too often restricted to boundaries drawn by public systems, and to the outlook of those who work within them. Definitions that draw on second era evidence are particularly prone to this error.
At Dartington, whenever we were involved in what is called place based reform, we concentrated on local authorities, or clinical commissioning group areas. (Only in Ireland where partnerships cut across these borders did we deviate from this norm).
We always started with epidemiology, a drawing of patterns of need across the place, the rectangle in the diagram below. Everywhere we tried this we came across 20 or so percent of the population with some combination of impairment to health, learning or social development. We called this the red circle.
We then worked out which citizens were getting help from what we called ‘high end’ public systems of mental health, special educational needs, justice or social care. This group also measured around 20 per cent, captured by a blue circle.
But note that the red and blue circles don’t overlap much. There is a whole story behind this. But that is for another day.
Only towards the end of my time at Dartington did we wonder about the third circle. If people were not getting support from high end public systems, where did they look?
The answer lies in civil society. When we looked we found that most people get their support from civil society, from family members, neighbours, activists in the community, teachers offering pastoral care in their own time, civil society organisations not supported by the state…..
If you are reforming a place -what arrogance we had in our second era days!- it doesn’t make sense to leave out of your work the people who do most of the heavy lifting.
1. There is huge variation between public systems, but civil society is the constant, the connector.
2. The direction of travel has been public systems to civil society. How can public systems get civil society to do the right things (to improve outcomes). What are the opportunities for civil society to unlock public systems?
3. There is too much ‘them’ and ‘us’. I live in civil society. I work in a public system. When I am in work I talk about them in civil society. Them are lots of me. We draw a world of them. We don’t capture the world as it is.