In this post our guest blogger Jane Mansour showcases the Family Independence Initiative in Boston, Massachusetts. The project is a good example of the principles of ‘guerilla policy’ in action. Jane is an expert and consultant in international welfare to work and the commissioning and funding of public services. She blogs regularly at Buying QP. Thanks to Jane for contributing the post, and we welcome your comments.
The argument for the benefits of user and staff involvement in policy making is considerably strengthened by numerous example of projects that have been successfully designed and delivered using this blueprint. These range from actual projects – of which FII discussed below is a great example – to the use of a crowdsourcing approach to gather solutions for identified and specific local needs. These raise questions about the extent to which this approach is scaleable, and how this can be done without losing what made them work in the first place.
This week I met Jésus Gerena, the Boston Director of the Family Independence Initiative (FII). FII families create support networks in their own communities rather than accessing help through a key-worker or institution. As an organisation it has impressive results – in the first six months of operation participating families in the Boston wing of the programme saw their incomes rise by an average of 13% and their savings by 22%. These statistics and many others covering family finances, schooling (both adults and children) and health and activities are compiled monthly. The data is actively uploaded by the participating families themselves. They are paid for this, and for leading, counselling and facilitating the monthly groups they attend. These payments total in the region of $2000 a year per family.
The FII was the brainchild of Maurice Lim Miller; he was honoured this week by the MacArthur Foundation with a ‘genius award’ which carries with it a grant for $500,000. It works by not helping people in poverty. No, that was not a typo. The FII do not help, staff can be (and have been) fired for doing so. What the FII does do is provide an environment in which people have opportunities to succeed. Families work together to problem solve, record their gains and losses and have access to resources should they need them.
There are the three fundamental values that underpin the organisation’s approach. Firstly, the families are in control. Secondly, there is a formal feedback loop consisting of monthly and quarterly meetings and data collecting providing peer accountability. The process of recording information in and of itself, impacts positively on behaviour. Lastly there is access to resources to move forward. These resources are often in the form of matching or doubling the contributions participants make towards education, housing or business goals, but they can also be used to meet urgent practical needs (eg. a car or dental work).
Listening to Gerena’s passion for the FII approach, it is difficult not to get excited about it, about the way that this organisation is not only challenging much of the way that social policy has been cast, but is succeeding in doing so. The scaleability of successful but reasonably small projects is fraught with difficulty. The world of public policy is littered with examples of innovative projects that are hailed, placed in the spotlight, enlarged and ‘replicated’, but that then fail to deliver on the bigger stage. This is then followed by a blame game that often focuses on delivery, sometimes on commissioning, occasionally on design.
In two years the Boston operation has grown from 35 to 200 families. Gerena thinks there is the potential to continue expanding to 1000 families but, and it is an important but, this expansion needs to happen organically through families introducing themselves and others – a combination of ‘core catalyst families’ and ‘ripple families’. Scaling up fails when the guiding values behind success are confused within the method in which they are delivered, when the ‘how’ is mistaken for the ‘why’.
There are broader public policy lessons to be learned from the work being done by FII. These are not that welfare savings can come from the wholesale removal of frontline staff, or that bids to deliver programmes should need to be scored on how often the words ‘family’ or ‘social capital’ occur, or that a new New Deal for Communities is the answer. The lessons are far more challenging than simply producing a shiny new programme.
Miller has written a brief paper identifying the changes he thinks necessary for substantial change in the outcomes for low-income families. It’s worth reading in full. His final call to action identifies four changes that need to happen:
“1. We need to more accurately communicate the resourcefulness, capacity, and caring that is the true picture of lower income families and communities
2. Funders must allow for program approaches that provide help based on family and community initiative and strengths
3. Policy makers, funders and leaders must seek direct feedback from the consumers of programs they create and respond to that feedback
4. The target families must self organize and advocate for themselves and their communities”
As I sat in the FII office, it was striking that there are clear echoes in the UK – in terms of approach, positive outcomes, frustrations with the system, but also in the difficulty in capturing the wins and replicating them either regionally or nationally. Successful, sustainable ideas are evident in individual programmes but somehow the key to why they work gets lost in translation when ‘reform’ or scaling up occurs. Why is it that successful local programmes so often fail on the big stage? To what degree would this failure be mitigated by taking a different approach to both entrenched social issues and institutional frameworks? What impact would the following considerations have on policy design?
Long vs short-term investment: FII is aimed at the working poor – those who are increasingly ineligible for state safety nets, face significant marginal tax rates on any additional earnings and are in real danger of sliding back into poverty (cycling between work and benefits). It relies on the safety nets being there, it is an extension of benefits rather than a replacement for them – any savings to the welfare budget will only be felt in the long-term as people move up the income ladder. When the focus is on cutting spending rather than raising revenue, and results are needed quickly the long-term nature of many interventions is overlooked.
Look for ‘A Duh’ rather than ‘A Ha’ moments (Gerena’s phrase). There is a tendency to look for exciting, new, revolutionary change but often small, practical, simple and obvious opportunities are overlooked. Users and staff are the key to understanding what these are.
It requires a significant power shift to trust in people to make decisions about their own lives, find their own support network and provide the resource to enable them to make positive changes. What could this look like and how can it be supported by the state?
The need to end funding silos for people with multiple needs has been much discussed. The introduction of the Universal Credit in the UK aims to streamline benefits. The focus is on simplifying the benefits people receive rather than on the way they live and how services they interact with are funded and delivered. Bringing funds for the latter into one pot (universal support?) would have a very different impact.
What and how do incentives work for middle and high earners? Can the rewards for initiative they receive be extended to benefit claimants and those on low incomes? Skills policy and funding is an area that immediately springs to mind.
Feedback and data are both vitally important and often overlooked. This involves a change in perspective, from the compilation of simplistic league tables of outcomes towards rich seam data mining of the information gathered on the journeys of individuals as they bounce around the system.
There has been a tendency in policy design in the UK and elsewhere to believe that successful programmes will only come from providing more intensive external support. The experience of FII is that the ongoing cycling between work and benefits can be prevented through the creation of long-lasting social structures and support networks, underpinned by feedback and resources. The challenge is in reproducing co-operative policy making and delivery on a regional or national stage.
 These outcomes have improved over time and the experience of the two Californian programmes is of an income increase of 20%.
 These sums are not included in the increased income calculations
We love public and voluntary service bloggers. At their best, they capture the day-to-day reality of public services in a way that Westminster-commentators can’t – and they have the real expertise and insights we need to improve social policy. Here’s our selection of the best frontline blogs we’ve read this week. Do send us your suggestions for great posts we’ve missed – and those frontline bloggers we should follow in the future.
Posted 10th October 2012
“This week George Osborne outlined plans to slash housing benefit for people under the age of 25 in both his conference speech and a Daily Mail article. This is part of a wider £10bn cut to the welfare bill… I’m presuming the subtext here is that if you’ve never paid into the system, you shouldn’t be able to take anything out. This shows such a profound lack of insight into the lives of many young people in the UK.”
Dr Tim, a junior doctor working in Tower Hamlets, tells the story of three young people – Max (19), Bea (22), and Nelufa (19) – that he has worked with and who would lose out if proposals to reduce eligibility for housing benefit for those aged under 25 announced this week become reality. He argues that these reforms would leave vulnerable young people like these destitute, homeless and isolated.
From Same Difference
Posted 6th October 2012
“Exactly two weeks ago today, I heard and wrote about the case of Liam Barker. Eighteen years old, paralysed since birth, he breathes through a ventilator. His parents had just received a letter informing them that in order to receive Employment Support Allowance, he might have to prove he is unable to work by attending a Work Capability Assessment.”
In this post Same Difference describes the experiences of two disabled people with complex needs, Ruth Anim and Liam Barker, who have been subjected to the Atos-managed Work Capability Assessment (WCA). Liam has received a letter informing him that he will need to undergo a WCA, while Ruth’s mother has successfully appealed the findings of her daughters WCA which found that she was fit for work.
From Abetternhs’s blog
Posted 5th October 2012
“I have written this because like many, perhaps most GPs I feel very uneasy about power. I aspire to a partnership with my patients, teamwork with my fellow health professionals and a more equal society. I feel very strongly that power is a privilege and medicine is a vocation and a public service, or as Iona Heath recently described it, ‘a labour of love’. Usually medical power is viewed in negative terms, an unreasonable acquisition of privilege and abuse of patient trust and public respect for personal gain. Whilst I don’t deny that medical power is abused terribly in this way, I am concerned that power is shifting away from professionals and democratically accountable government, and I am not sure that this is in our patients’ best interests…”
GP Jonathon Tomlinson challenges the current orthodoxy in healthcare by considering the implications of the power that healthcare professionals hold. He argues that notions such as ‘patient independence’, ‘self-care’ as well as regulation and outsourcing, are reducing the autonomy of healthcare professionals and disempowering patients. He speculates about what this could mean for the future of healthcare.
From Mike Broad, on Hospital Dr’s Dr Blogs
Posted 9th October 2012
“Don’t get me wrong. I’m not blaming the private providers – indeed I’m not against the use of the private sector under certain circumstances. They’re not snatching these cherries, they’re being offered them by commissioners desperate to reduce costs.”
Mike Broad argues that the Government is rushing to privatise parts of the NHS to ensure that its reforms can’t be unpicked by any future incoming Labour administration. He outlines his concerns that the Government is not sufficiently addressing the risk that the private sector will cherry pick the most lucrative procedures under the policy of payment by results in health.
From PC Bloggs
Posted 5th October 2012
“Reading media reaction to Hillsborough, to Ian Tomlinson’s death, to all the other negative news stories, is galling at a time when we also feel let down by our own management and the Home Office. I am sure many police officers up and down the country have been wondering just what we are doing it for.”
PC Bloggs describes how the outpouring of grief in the wake of the untimely deaths of PCs Fiona Bone and Nicola Hughes has brought hope that the police service still commands public support in the wake of cuts and negative news stories. PC Bloggs argues that Big Society isn’t a replacement for public services, and that recent events point to a very different relationship where public professionals are valued and respected for the contribution they make.
From The Magistrates’ Blog
Posted 9th October
“Off to court yesterday morning. Standard kind of court list, three CPS trials listed, 2 in the morning, 1 in the afternoon. The subject of the charges also pretty usual, a couple of Assault by beatings (Common Assault) with domestic violence overtones and a Harassment without violence. In we go at 10 am all fired up having had some Case Management Training on Saturday…sadly it all went downhill from there.”
Bystander J, posting on the Magistrates’ Blog, describes three cases where the trials could not proceed because of bureaucratic barriers and lack of joined-up working between the courts and the Crown Prosecution Service.
From The World of Mentalists
Posted 11th October 2012
“This idea that claiming benefits is a lifestyle choice is as hilariously preposterous as it is bullshit. Who would even entertain the notion of choosing this ‘lifestyle’? It’s a horrid way to go through everyday existence, as I can wholeheartedly assure naysayers. …Are there scroungers out there? Yes. Do they need weeded out of the system? Yes. Of course they do. But not at the expense of the vast majority that claim due to genuine illness. And it is a majority.”
To mark the passing of the Welfare Reform Bill by the Northern Ireland Assembly, The World of Mentalists spends the day listening to David Cameron’s speech day “in a state of raw terror [and] guzzling diazepam” – but at least it produces a good rant.
If you’re a frontline blogger, do send us your latest blogs on policy issues or posts from the past that you’re particularly proud of, and they could be included in next week’s round-up. Get in touch with us at: firstname.lastname@example.org or via Twitter @guerillapolicy and @guerrillapolicy
The West Coast mainline franchising fiasco shows that the current approach to outsourcing public services has serious flaws that need to be addressed – the much too complicated and secretive nature of outsourcing is the problem, rather than the people handling the process.
Last week Patrick McLoughlin, the new Transport Secretary, cancelled the West Coast Mainline franchise deal. The Department for Transport has been on a damage limitation exercise ever since, with McLoughlin blaming the fiasco on officials at the DfT “because of deeply regrettable and completely unacceptable mistakes made by my department in the way it managed the process”. Philip Rutnam, the Permanent Secretary at DfT, has also joined in telling staff that they must accept that the reversal was the fault of officials. Meanwhile, Kate Mingay, one of the three officials suspended by DfT (an ex-Goldman Sachs employee parachuted into the civil service because of her private sector expertise) has hit out at the way her role in the procurement has been portrayed by the Department.
Blaming officials is an easy way to distract from the substantive story: whether the current approach to franchising used by the DfT is fundamentally flawed. The Department argues that mistakes were made from the way the level of risk in the bids was evaluated due to human error – in particular the way in which inflation and passenger numbers were taken into account, and how much money bidders were then asked to guarantee as a result. But the assumptions about inflation and passenger numbers are dependent on the state of the UK and global economy and the ability of the future franchisee to bring in new customers. Colin Cram, writing for the Public Leaders Network, argues that: “…this enters the realms of guesswork and slight changes in assumptions can lead to different outcomes for contracts that may be for only three or four years, let alone 13.” If the Government’s own Office for Budget Responsibility continues to get its predictions on economic growth significantly wrong, how can we expect the assumptions made in the rail franchising process to be watertight?
This is not the first time that assumptions about economic growth and customer numbers has gone wrong, for example the previous experiences with the East Coast mainline or in the commissioning of welfare to work services. The Work Programme was designed for a far more positive economic climate than we now find ourselves in. DWP’s estimates of the number of customers in receipt of Employment Support Allowance have proven to be wholly unrealistic, with serious consequences for the business models of prime contractors and charities.
The risks associated with complex procurement processes such as the rail franchise are compounded by the secretive nature by which they are often conducted, behind a veil of ‘commercial in confidence’. As we’ve argued before, this ‘closed shop’ approach leads to poor decisions and a profound lack of public engagement – until something goes horribly wrong. The complexity involved also means a significant diversion of resources into the process of franchising rather than actual delivery of services. Franchising might work however if the process was more transparent and the assumptions about passenger numbers (and any other projections) were open to rigorous scrutiny by others outside of the process – so why isn’t it?
The West Coast fiasco has much wider implications that the policy establishment probably doesn’t want the public to consider. Cheryl Gillan, the former Conservative Welsh Secretary, has argued that a root and branch re-examination of the High Speed 2 rail project is needed if the public is to have trust in such a significant investment of public resources. Instead, plans for competition and outsourcing are being accelerated in prisons, probation services and health. In this context, the secretive, complex and bureaucratic nature of outsourcing needs to be addressed as a matter of urgency. If the public is going to be on board, then a public debate is needed on the merits and risks of delivering services in this way – which surely is what the Government’s open policy should be all about.
Fundamentally, the political establishment doesn’t engage the public in a debate about the merits of rail franchising because the public doesn’t support the idea. This ‘outsourcing by stealth’ approach wins neither hearts nor minds. Various surveys continue to show a strong majority of public opinion in favour of re-nationalising the railways – one recent survey found that 70% of respondents supported such a move. Impossible? New Zealand provides an example of such a policy put into action. Its rail and ferry network was privatised in the 1990s and asset-stripped and run down by an Australian outfit. It re-nationalised both in 2009. Michael Cullen, the then Finance Minister said privatization had “been a painful lesson for New Zealand”. Kiwi Rail in public hands has been able to invest in its long-term future whilst also generating significant financial and economic benefits for taxpayers in New Zealand.
Here, despite the strong public preference for a nationalised rail network, none of the three main political parties are committed to such a policy. At last week’s Labour Party conference, Ed Miliband and Maria Eagle made positive noises in this direction but no firm commitments. So we are left with an unpopular, risk-laden, fragmented rail network – and the policy establishment searching around for scapegoats when they should be looking somewhat closer to home.