Speech at the Scottish Parliament, January 2011
This is what I want to do this morning, if it’s OK by you. Three things.
First, to explain a little bit about where the ideas behind co-production came from, and especially the word. We have to somehow come up with an excuse for the word.
Then to say something about what co-production isn’t about. Rather more controversial that one.
And finally to say what I think some of the unexpected implications of these ideas for our public services now. Perhaps not unexpected for an expert audience like you, but I set them out nonetheless.
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I first came across the idea in practice in the USA in 1996 when I went to a hearing of the Washington Youth Court, which now tries a third of all the young first-time non-violent offenders there.
The court is a brainchild of one of the key pioneers of co-production, Edgar Cahn, of whom more later.
The main point about it is that the jurors are young offenders themselves who have already been through the court.
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It’s a brave and hugely successful project, which has gone beyond the experimental stage.
What’s important here is that it offers an answer to a very ancient conundrum.
How do you persuade young people to be advocates of good behaviour?
The answer suggested here is that you share with them the responsibility for enforcing it.
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I was fascinated by this, and similar projects, and managed to bring Edgar Cahn over to London and Newcastle in 1997. He was interviewed by Libby Purves on the Midweek programme and they got over 400 letters in response.
Overnight we had what turned out to be the beginning of a movement.
But of course that wasn’t really the beginning of co-production in the UK. What is bundled up in here are a whole range of ideas from self-help, via asset-based community development and self-build. And a lot more besides.
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There has always been a tradition of co-production in public services here. Parents in classrooms. Expert patients.
But let’s go back to the ideas around the term co-production. One answer about where this came from is that it, in some ways, it came from Chicago.
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It was here that Elinor Ostrom, the current holder of the Nobel prize for economics, was asked by the Chicago police to tackle a particularly confusing question for them.
Why was it that, when they took their police off the beat and into patrol cars – and gave them a whole range of hi-tech equipment that can help them cover a larger area more effectively – why then did the crime rate go up?
This is not just a question confined to the police. It lies at the heart of why public services become less effective on the ground as they become less personal and more centralised.
Elinor Ostrom’s team decided that the reason was because that all-important link with the public was broken. When the police were in their cars, the public seemed to feel that their intelligence, support, and help were no longer needed.
She called this joint endeavour that lies at the heart of all professional work co–production. It explains that doctors also need patients. Teachers need pupils. Politicians need the public. If they are going to succeed.
So next time, you find yourself looking across one of those desks at doctors, just remember – they need you as much as you need them.
But not just you. One of the insights of co-production is that they don’t just need the patients, they also need their families and their neighbours.
So Chicago.
Chicago is also the city which Robert Sampson studied in the mid-1990s with his team from the Harvard School of Public Heath. Trying to get to grips with the social factors behind violent crime.
They split the city up into more than 900 different neighbourhoods and found, to their surprise, that none of the factors that are traditionally supposed to make a difference to crime – poverty for example – really seemed to be relevant.
What did make a difference was what you might call a latent sense of co-production among people. It was whether they were prepared to intervene if they saw youngsters hanging about.
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It was about trust, in other words. But because this was Harvard, they needed a more impressively complicated word to describe it, and Sampson called it ‘collective efficacy’.
He described it as a “shared willingness of residents to intervene and social trust, a sense of engagement and ownership of public space”.
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So there are three very important linked ideas here, which I would summarise like this.
First, that professionals need their clients as much as the other way round.
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Second, the implication of that. Which is that service users who are supposed to be such a deadweight on an exhausted public service system, are also assets.
Miserably wasted by the current system.
This is one of the key contributions of Edgar Cahn.
Not to do the same as the professionals. Not brain surgery. But a resource for providing the kind of human skills and support which service systems find quite hard to do.
Befriending. Listening to. Teaching maybe.
Visiting when they’ve just come out of hospital to see if they’ve got food in the house.
All those other broader elements of public services which ought to be there but aren’t.
The third idea is around the concept of a Core Economy, coined by the economist Neva Goodwin.
The idea that all this local activity, parents bringing up children, looking after older people, making neighbourhoods work, is not some magically inexhaustible resource outside the economic system.
It is what makes the rest of the economy possible.
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Our first real venture at the new economics foundation into this territory was to launch a time bank as part of the Rushey Green Group Practice in Catford.
I should say about time banks that they are one way – just one way of making co-production effective in public services. But this one is a good example.
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Our intention was to help the doctors broaden out what they could offer.
Not just visiting services or healthy walking or fresh vegetables, but also a network of mutual support to help people find that, suddenly, without quite realising it, they had a useful and necessary role.
Which is not only, it seems to me, a basic human right, but can also be transformative.
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The small-scale DIY service we pioneered there borrowed from a similar idea in Brooklyn. I remember there was one lady who lived in the dark because her curtains were too heavy to draw.
Co-production meant being able to fit lighter curtains.
Very simple things, like changing a light bulb, but they make a huge difference.
And try getting those done by conventional services. Even in the days of plenty.
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So I’ve left it until now to try and define co-production. This is the working definition we’ve been using. It certainly isn’t final. It isn’t even definitive.
It is largely, as far as I’m concerned, about delivering services. It is about doing. And the purpose is a shift in the power relationships around services, philanthropy and charity.
This is important and I’ll come back to it.
The other thing about co-production is that it is a little like Asperger’s Syndrome.
In the sense that there are whole range of possible symptoms and you don’t have to have more than one or two.
We usually talk about six of these characteristics.
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Designed to build on people’s existing capabilities. To seek out what they can do, not just define people by what they can’t do.
Providing services which depend on reciprocal relationships between professionals and clients, or services and communities.
Encouraging mutual support networks among users, especially to take over from professionals at the inevitable moment when professional help moves on – which it does even in the most generous public service set-ups.
Blurring the distinctions between professionals and users.
Organising services as catalysts for broader services.
Recognising users as assets to the service. Like Rushey Green.
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Which brings us back to the definition, and the more controversial business of saying what co-production isn’t.
And you’ll see here that we emphasise the delivering. There’s no doubt that user management or consultation are co-production in a sense.
Of course they are. And they are hugely important for other reasons.
But co-production emphasises people using their human skills.
Not their advice.
Not their instructions to managers.
People don’t become mini bosses in co-production – they are just recognised for their potential to broaden and deepen services because of what they do, not because what they think.
It is doing that’s important.
Co-production denies that professionals are the only ones that do things.
So not consultation. But also not, it seems to me personal budgets. Or not quite.
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Again, these are hugely important innovations. But the danger, from a co-production point of view is that those who receive them can get flung into an atomised world, where they have to pay people to come to the pub with them.
Where personal budgets are relevant is where people can use them to produce the kind of support networks that means they don’t have to pay for friends. Personal budgets are not sufficient for that.
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And then again, co-production isn’t what I would call trolley management.
The Australian post office says that, when people put their postcodes on correctly, they are co-producing postal services.
Some supermarkets claim that people are co-producing when they stack their trolleys obediently and neatly, and get their £1 coin back.
This is not co-production as I understand it.
The whole purpose here is to change the power relationships.
To give people an equal stake in their services.
To give them a means by which they can provide themselves with the kind of support they need.
To reach out upstream of problems and prevent them.
Not just to save money for managers.
Without that objective of change – without that promise of transformation for both sides – then co-production is just nudging.
It’s just manipulation, and it won’t have the staying power to work sustainably.
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So there’s the key point. The heart of what I wanted to say. Co-production is about change.
If it isn’t, it isn’t co-production.
In fact, this is a critique of public services which lose their dynamism.
Which just try the same thing over and over again and get the same results. The triumph of hope over experience,
It is also a potential explanation for the big mystery, it seems to me, about the welfare state.
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This is the 1942 Beveridge Report. This is what all those servicemen carried into battle with them.
And it assumes, as you can see here, that services would get cheaper.
It didn’t happen.
It wasn’t that the welfare state failed to vanquish his five giants – Ignorance, Want, Squalor, Disease, Idleness.
It was that they came back to life again for every generation and had to be slain all over again.
Why? This is such an important question. So important, maybe that we hardly dare ask it.
Co-production suggests an answer. That there is something about delivering services to people who are supposed to accept them gratefully and passively…
Sometimes extremely passively – which undermines their ability to resist.
Which disempowers.
Which undermines their ability to be heroes of their own lives.
And something about reciprocal services, where we ask people for something back, and give them the respect that goes with being equal partners in delivery, which can turn that situation around.
And there, in a nutshell, is the case for co-production in the UK.
We are in the earliest stages of all this.
The research looks good, but the light is only just seeping into the sky as far as co-production is concerned.
But there are potential answers here for a wider set of questions.
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It also has implications for the direction we want to travel in.
One of the difficulties for pioneer co-producers is that they often seem to fly in the face of the way public services have been developing over the past generation.
They rely on face to face influence when the trend has been virtual.
They appeal to general skills when the trend has been increasingly specialist.
They believe in ordinary skills, amateur in the best sense, when the trend has been increasingly over-professionalised.
Most important perhaps, as we’ve seen, co-production relies on the idea that the users of services, and their families and neighbours, are a vast untapped resource – when the trend has been to regard them as drains on an overstretched system.
Because of this, coproduction represents a seriously different idea of the future of public services.
Which can use these new resources to reach out upstream of problems and prevent them from happening in the first place.
It’s an idea of public services which are, as their basic purpose, hubs to make possible a massive increase in voluntary activity.
Not through the voluntary sector but through the public sector.
They are catalysts for knitting society together again around them. But only if they co-produce. Only if we use the resources that people represent.