Hands off our Ombudsman we say. The Public Administration Select Committee has taken a look at the Big Society and is not sure what it sees. The Big Society seems to have become a curiously insubstantial reincarnation of the wooly mammoth – is it real or just a ghost that haunts the cracks and corners of our public life, trumpeting faintly? Is it still out and about or are we seeing an illusion created on a film set in the Parliamentary zoo?
Risk of Infection
But the uncertainty that dogs this initiative should not be allowed to infect institutions that are functioning perfectly well doing the job they were set up to do. The fear is that the Ombudsman becomes the cheerleader and the policeman for Big Soc programmes – promoting local resolution, specifying remedial actions. This is the way to the Heffalump pit of enforcement – ie making sure that what is specified is done.
The report has a chapter on accountability, equity, representation and management (and all this is a chapter only 3 pages long). For me the interesting idea that has applications for the areas we work is that those concerned with Big Soc projects could work more flexibly and confidently if they take a ‘murky view’ of success – a view which is more nuanced and broadminded than ticking the one box called SUCCESS!.
The Moore Adamson Craig Partnership have always favoured a metric of success – otherwise how do people know what they have achieved? However in the world of volunteers – like people coming forward to be a patient representative in a GP surgery – there is always this mix of the personal and the communatarian.
Understanding the Needs
Participation can be prompted by personal need as well as community need and in health matters the personal is often the far stronger motivation. This only becomes a problem if the personal remains so dominant that it precludes that person developing the skills and the perspective that allows her or him to use the personal as a basis for the general agenda. Matthew Taylor’s blog is referenced by the committee where he writes about the irredeemable anecdotalism of the Big Society with the consequence that ministerial policy is vague and uninformed by any evidence. However in our view, the anecdote in matters of public engagement is often where an issue kicks off with the evidence becoming stronger as the anecdotes accumulate.
A Matter of Political Inconvenience
However would we be too cynical to say that anecdotes that support a ministerial point of view are embraced while the ones that do not, are ignored even when a lot of time and energy has gone into organising feedback. I remember us agonising over the format and content of our local LINks Annual Report to be submitted by all to the Secretary of State for Health. There was such potential there to pull out common threads based on the patient representative experience. What happened? Can’t remember and now it is too late with LINks becoming another of those ghosts of PPI past that haunt the NHS patient participation landscape. Any evidence that might support the continued existence of these organisations has to be ignored since it is politically inconvenient. The Big Society revolution is certainly fulfilling that hoary revolutionary maxim whereby revolutions devour their own children – in this case the institutions that might have played a considerable role in achieving the NHS version of ‘murky success’.
The Moore Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations. We are ready to work with and support all those who want to make sense and a success of the new structures of patient and public engagement within the new arrangements for health and social care commissioning and providing. Feel free to contact us to discuss the opportunities.