What next for the welfare state?
Hilary Cottam, founder of social enterprise, Participle, talks to Fabiana about relational welfare
The welfare state: where are we now, Hilary?What is working and what is missing?
It is essentially the same welfare state that we had in the 1950s, and we have had 20 years of trying to reform it around the edges. The reality is that British society has changed but our welfare state is still built around a white male breadwinner while care, a huge role of the state, is pushed off, unpaid, into the women’s domestic realm. There are problems today that Beveridge never considered when he designed it: for instance, I work on ageing. Over 60% of the British population is over the age of 60. Another example is our health economy, all organised around hospitals and infectious disease when 80% of the health burden now is chronic disease and shouldn’t be medicalised.
With all these issues coming together, we need a radical settlement around the state, society and business and a very new, dynamic relationship between the state and the citizen. The Labour Party did make things happen – such as SureStart – but we need a fundamentally different welfare model. The Labour Party understood the state and it didn’t understand the citizen; now the Big Society talks about the citizen but has got no conceptual model of the state, which is equally problematic.
You have defined what we need as a more relational welfare: what do you mean?
We need to move away from a model about a transaction which passes goods and services to people, that does things to people, to one about engaging with people and doing things in relationship with people. The idea of relational welfare works on three levels for me. One is methodological to re conceive the welfare state we need a completely different vantage point: approaching it from my background of feminist academia, of psychoanalytic thought rather than the sphere of production or consumption, immediately makes you ask different questions. Secondly, there are huge issues about time and how to balance our lives.The third set of considerations are about welfare in terms of services and the state, and here we need to see how to solve problems collectively, in dialogue, working together.
How would that work in practice?
In all the public service work Participle does, one of the most important things is the way people talk to each other. For instance, when our families in crisis choose the life team, they are looking for people who will talk to them as I am talking to you now as equals, in an open way. For me,this is relational welfare. It is a kind of cultural, attitudinal change as much as a change in what is actually delivered.
Our work on ageing is another concrete example of relational welfare.The system of adult social care in Britain is one rationed by economic status, how much money you have, and your physical ability. But our work clearly shows that people are in greatest need of social relationships. As the WHO says, loneliness is a bigger killer than smoking. People judge their meal delivery or their cleaner according to whether they’ve been able to talk to them, not only by the food or cleaning received.Taking all these insights, we’ve built a universal service called Circle, basically a community membership service. Instead of a public sector service being done to you, you join something, you own it, feel like a member, and the traditional boundaries are very blurred between who is providing the service and who is receiving it. I might be very bad at technology so someone is helping me with that, but I’m helping you because I’m taking you out of the house for a walk, or meeting you out of hospital.This particular example is cheap, and it is saving a lot of money, because it is built on software rather than on buildings, vehicles, all that kind of thing. And it is built on social capital, on us being each other’s solution.
We designed this service bottom- up in Southwark, with 250 older people and, importantly, their families. Circle would not have been invented by 250 people getting together alone in a church hall without resources.To design our project, there was major state participation and investment, in really rethinking, in a very systemic way, where resources are, what’s needed and how we can shift that system.
“Welfare reform must bring a very new, dynamic relationship between the state and citizen”
How would women benefit from a relational approach to welfare?
The gender issue is the challenge for relational welfare to solve, because care is still predominantly the woman’s role, and the old welfare state has not found a way to resolve this. Traditional welfare, and public service reform, is held within very traditional categories of production, consumption, subject, object, and all of those categories have broken down. Power is diffused in a very different way, so I think the lens of relationships enables us to bring them back into the political debate, which is a start- ing point, without which we can’t go anywhere.
Looking closely at relationships also enables us to tackle the outdated presumption of care being in the home and the woman’s role, while production and consumption happen outside.The caring roles are still being pushed onto women, from mothering to caring for a relative, and in late capitalism it has become more difficult to think of a way to address those issues.
Funding the welfare state is essential but so is the principle, the intellectual frame- work that we are talking about. I cannot believe that all my conversations with my girlfriends and the mums at school are still about how we cope with the basics of our daily lives like childcare and balancing everything, even with a supportive partner! I don’t see that it is going to be any different for my daughter as things currently stand.The welfare state needs to change, and it is a cultural change that we need, to enable people, women in the first place, to develop their capabilities and unlock their talents.
14 Fabian Women’s Network e-magazine