The author Andre Gide said: “Everything that needs to be said has already been said. But since no one was listening, everything must be said again.” How true. Real social and economic change can only happen through collaboration. Our failure to recognise this undermines our ability to create services for the public that can withstand the challenges that are inevitably ahead.
There is a large conspicuous gap where a Whitehall-level narrative about public services used to be. Neither main party seems hugely interested beyond a bit more public interest in markets (welcome), a crisis-driven focus on housing (also welcome), and an ethereal discussion about funding levels that won’t get any more specific until we can read the runes of Brexit more clearly.
The rumbling discontent over universal credit speaks to a disconnect that feels bigger than ever between the centre and the periphery. As one MP observed recently, the road to hell is paved with good intentions. But when you have a chance to avoid getting to that destination, why wouldn’t you take it? The bandwidth of central government is being seriously tested, and it takes courage to stop, think and build new coalitions for change.
Such is the tone of the Care Quality Commission’s State of Care report published this month. It called for “more collaboration and joined up care”, with implications for both commissioning practice and the balance between collaboration and competition within the provider market. We should emphasise the relational nature of care and the need for structures and strategies to support this. Initiatives like Thrive in the West Midlands and London, which aims to improve mental health and wellbeing, show that it takes a mix of movements, momentum and committed delivery to start changing a culture for the long term.
A testing financial climate naturally still dominates the agenda for public services. The language of austerity may have shifted slightly, but much of local government is still scratching to achieve seemingly impossible year-on-year savings, and the health service remains in a politics of permanent semi-crisis. We might reflect that the financial crisis did indeed stimulate innovation and change; but it also narrowed horizons at a time when social progress and financial sustainability are more complex to achieve than ever.
The next phase of reform for public services needs to be about deep and meaningful cross-agency collaboration; and the role of central government is to create the conditions for it to happen. A working industrial strategy is impossible to achieve without this – there are too many contradictions in the system that mean organisations that could be working in concert are like ships in the night.
The concept of transformation has, in this context, been quite unhelpful: a false promise, or a way of describing covert activity to cut costs and squeeze processes. Or it’s a necessary evil in the eyes of government – “just get it done”. But the long-term cost is a failure of imagination and an erosion of capability.
Collaborative change starts from a different place. It asks: what can we do together that we can’t do on our own? The world out there is getting more complex – and the changing shape of public service demand reflects this. Anyone working at the coalface this winter will immediately recognise the insidious links between homelessness, housing, substance misuse and mental ill health, for example.
Areas like the West Midlands are trialling more holistic ways of meeting these complex challenges. We should be encouraging these approaches, and creating incentives for places to work across silos and in collaboration.
Later this year the Collaborate Foundation – our sister organisation – will be publishing the first in a landmark series of annual reports on the State of Collaboration. Our vision is to bring robust quantitative analysis to the gap between rhetoric and reality around cross-sector working, and to understand what people think it really takes to make system change work for those who need it the most. For me it is a real “watch this space” moment. And as Andre Gide reminds us, the need has never been greater to re-state the case for collaboration.
