Dr Hilary Cottam - Social entrepreneur
Hilary is an internationally acclaimed social entrepreneur whose work in Britain and around the world has focused on collaborative and affordable solutions to some of the greatest social challenges of our time: challenges such as ageing, loneliness, chronic disease, good work and inequality. She is the author of ‘Radical Help: How We Can Remake the Relationships Between Us & Revolutionise the Welfare State’.
The future of society
Is our welfare state fit for purpose? Few of us think so – but what should we do about it? Traditionally we adopt positions according to our politics: the Left say we should invest more money in existing institutions; the Right say efficiency is the answer.
I think our troubles run much deeper and our possibilities are wider. I also think we have lost sight of what matters – the bigger question that once sat at the heart of our welfare state: how we can we flourish? This is why I wrote Radical Help.
The welfare state transformed our lives: providing decent homes, universal education, a new health service and good, well-paid work. It was emulated the world over. But it was designed for a very different era, a different economy and a different set of problems.
In Radical Help I argue that there are three reasons why our systems are no longer fit for purpose and cannot be fixed.
Firstly, we face new problems – problems like loneliness, depression, chronic disease, the pressures of demographic change, of living on a fragile planet – problems that were not foreseen when our welfare systems were designed.
What’s important is not just that these problems are new, but that they are different in nature – they need a different response. Loneliness for example – a modern killer – cannot be solved by a Minister or a top down service: it requires a new approach that fosters the bonds between us.
There’s a second major challenge: the social and economic structures on which the welfare state was based no longer exist. There are no jobs for life nor can we any longer rely on women’s unpaid labour to do the job of care. Both of these changes have provoked crisis.
The third reason our welfare state cannot work is poverty. Poverty has not gone away – in fact it is deepening, morphing and changing shape. Today most people who are poor are in work. Nearly half of all working families in Britain are supported by benefits. But no one wants to live on handouts – they want good work that is decently paid.
And there is another form of poverty that is strangling us – the poverty of relationships. We don’t know each other anymore. The digital economy is widening the economic gaps between us – between those earning the dizzying sums enabled by the algorithms of high finance and those doing the traditional work – of care for example – living precarious lives on minimum wages or worse.
These gaps in income are reflected in chasms of geography. This matters, because as research shows – it is our relationships and who we know that above all will predict our life chances – what kind of job we will get, our health and who will take care of us in the end.
Modern poverty is about a lack of money and a rent in our relationships. Our welfare state has no answers.
We could make change. I propose six shifts that together would bring about a radically new welfare state. The first shift is conceptual – we need a vision. Not a management target of how we can deliver better – but a big and shared vision of how we want to live.
The second shift must make this a reality rather than an empty promise. We must leave behind a set of services that manage our needs and create new systems of support that can help us grow the capabilities we need to flourish.
Today 80 percent of the resource available is spent on the system itself: assessing, referring, managing the queue. This is entirely unproductive. We need instead to invest in change.
This framework is not a theory – it was developed through practice. I have been working with thousands of people across the country, rooting myself in their every day and asking – what would you do? Together we designed new ways of finding and progressing in work, new forms of health care, new communities providing joy to elderly members. These solutions change lives and – supported by technology – they are affordable.
These are approaches that take care of everyone: those who are stuck revolving in our systems and those whose role it is to take care of us – the thousands of dedicated professionals who currently cannot do good work in bad systems.
This "is a time for revolutions, not for patching" William Beveridge audaciously declared in the opening pages of the Beveridge report – the blue print for our welfare state. Standing in the ruins of war and recession Beveridge saw that the welfare systems inherited for the 19th century would not work in the 20th and he dared to dream. We must do the same.
This would be radical help.