Labour's next big idea: the "relational state"

Recognising the importance of human relationships could revolutionise public services.

Sparked by the financial crisis and subsequent recession, the Labour Party has been engaged in a serious debate about the core tenets of its economic policy. And there is little doubt that Ed Miliband has started to carve out a distinctive position on "responsible capitalism". However, there has so far been much less discussion about Labour’s approach to public services. If the party wins the next general election it will assume responsibility for a state both substantially reformed from the one it left in 2010 and under unprecedented financial pressure.

There is much of which Labour can be proud from its recent period in office: NHS waiting times, crime rates and school failure all tumbled. However, there was collateral damage from achieving these results, requiring a re-assessment of the party's dominant approach to running the state. The desire to demonstrate "delivery" led to a vast increase in command and control management techniques, which, while sometimes necessary to deal with appalling performance, tend to alienate the workforce and crowd out space for responsiveness and experimentation.

The correct instinct to give citizens power over public services narrowed to a choice between providers, neglecting the many ways in which people might shape the services they use. And the case for institutional pluralism and diversity beyond the public sector was often reduced to a fight about competition. Elsewhere, the drive for high standards of "customer service" was inattentive to the role of public services in enabling people to forge relationships with each other and a sense of common life. And finally, the fear that any variation or contingency in service provision would produce unacceptable inequalities drove a bias towards centralisation and standardisation that sapped professional creativity and local mobilisation.

These lessons don’t mean abandoning everything Labour did in government, less still failing to defend the real strengths of its record. But they should prompt hard thinking about how Labour would govern in the future, not least because major challenges – from chronic health conditions, to anti-social behaviour and educational excellence – cannot be addressed by the state delivering solutions onto an unsuspecting public.

In an IPPR publication out today, we argue that combining the best instincts of "New Labour" and "Blue Labour" offers the outlines of a fresh approach to improving public services and governing the state. Like New Labour this should be firmly anchored on the side of the citizen, in favour of non-state provision where appropriate, and intolerant of poor standards. And like Blue Labour it should care about institution building, guard against bureaucracy, and focus on how services are run, not just what they achieve.

So what might that mean in practice?

Given the major fiscal pressures it would face, the first task for an incoming Labour government would be to set strategic priorities. We would put childcare and social care high on that list, but the party should find ways to involve the public honestly and directly in the trade-offs and choices facing the country. It might convene a delib­erative citizen’s convention to provide advice and input to politicians ahead of the next Spending Review.

Beyond this, Labour should set a small number of core goals and citizen entitlements in the main public services, leaving more space to innovate. In education, for example, the focus could be on a national attainment "floor target" for schools and an entitlement to catch-up support for pupils at risk of falling behind. In health, it could be waiting times and a right to GP access. But there can’t be a hundred "priorities".

In the end, public services are only as good as the people working in them. In the past, Labour used extra spending to oil the wheels of reform. With less cash around, a grand bargain is needed that frees professionals from a excessive compliance culture, draws them into shaping and governing services and challenges them to stand up to bad practice.

Rather than a tired debate of public versus private, the focus should be on a supply-side revolution led by a new wave of autonomous providers. Self-governing institutions, bounded from the over-reach of both bureaucracy and profit, are most likely to foster strong relationships and service innovation. For instance, while the focus is on the funding challenge, social care services are crying out for greater humanity and innovation, with new forms of mutual and cooperative provision in the lead.

A more relational state also requires the mobilisation of local leadership and initiative. So Labour should decide on those things which must be done nationally and decentralise power elsewhere – starting with our major cities. They could be put in charge of Housing Benefit and housing capital expenditure, with a remit to use those resources to make housing more affordable in their area.

Decentralisation needn’t stop at the town hall though. Citizens should be given meaningful power over services. This can be focused on both individuals (such as those with long term health conditions managing budgets and care planning) and groups (such as parents associations having a say on the governance and priorities of children’s centres).

Finally, the drive for strategic priorities, institutional independence, professional autonomy and local control must be matched by strong forms of accountability, which extend beyond just targets and markets. In education, this could mean all schools having academy-style freedoms to innovate, balanced by democratically accountable local school commissioners. Similarly, it could mean reducing the amount of statutory guidance for teachers, matched by longer and tougher probation periods so that poor performers are removed.

The political viability of pivoting towards a more relational state rests on the basic question of whether voters want a government that tries to solve their problems for them, or one which gives them power over their lives. Does the public want outcomes delivered for them or space to foster the relationships that matter?

In the past, politicians have tended to go into election campaigns promising better schools or more nurses. That might not work anymore, especially when the money to pay for such promises has dried up. But if such pledges are abandoned, what comes in their place?

These electoral dilemmas are not the place to start thinking about how the next Labour government might run the state, but they are among the places where this debate will have to end up.

Graeme Cooke and Rick Muir work for the IPPR but write here in a personal capacity.

Labour Party leader Ed Miliband addresses workers at Islington Town Hall on 5 November in London. Photograph: Getty Images.

Graeme Cooke is research director at IPPR

Rick Muir is associate director at IPPR

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Junior doctors’ strikes: the greatest union failure in a generation

The first wave of junior doctor contract impositions began this week. Here’s how the BMA union failed junior doctors.

In Robert Tressell’s novel, The Ragged-Trousered Philanthropists, the author ridicules the notion of work as a virtuous end per se:

“And when you are all dragging out a miserable existence, gasping for breath or dying for want of air, if one of your number suggests smashing a hole in the side of one of the gasometers, you will all fall upon him in the name of law and order.”

Tressell’s characters are subdued and eroded by the daily disgraces of working life; casualised labour, poor working conditions, debt and poverty.

Although the Junior Doctors’ dispute is a far cry from the Edwardian working-poor, the eruption of fervour from Junior Doctors during the dispute channelled similar overtones of dire working standards, systemic abuse, and a spiralling accrual of discontent at the notion of “noble” work as a reward in itself. 

While the days of union activity precipitating governmental collapse are long over, the BMA (British Medical Association) mandate for industrial action occurred in a favourable context that the trade union movement has not witnessed in decades. 

Not only did members vote overwhelmingly for industrial action with the confidence of a wider public, but as a representative of an ostensibly middle-class profession with an irreplaceable skillset, the BMA had the necessary cultural capital to make its case regularly in media print and TV – a privilege routinely denied to almost all other striking workers.

Even the Labour party, which displays parliamentary reluctance in supporting outright strike action, had key members of the leadership join protests in a spectacle inconceivable just a few years earlier under the leadership of “Red Ed”.

Despite these advantageous circumstances, the first wave of contract impositions began this week. The great failures of the BMA are entirely self-inflicted: its deference to conservative narratives, an overestimation of its own method, and woeful ignorance of the difference between a trade dispute and moralising conundrums.

These right-wing discourses have assumed various metamorphoses, but at their core rest charges of immorality and betrayal – to themselves, to the profession, and ultimately to the country. These narratives have been successfully deployed since as far back as the First World War to delegitimise strikes as immoral and “un-British” – something that has remarkably haunted mainstream left-wing and union politics for over 100 years.

Unfortunately, the BMA has inherited this doubt and suspicion. Tellingly, a direct missive from the state machinery that the BMA was “trying to topple the government” helped reinforce the same historic fears of betrayal and unpatriotic behaviour that somehow crossed a sentient threshold.

Often this led to abstract and cynical theorising such as whether doctors would return to work in the face of fantastical terrorist attacks, distracting the BMA from the trade dispute at hand.

In time, with much complicity from the BMA, direct action is slowly substituted for direct inaction with no real purpose and focus ever-shifting from the contract. The health service is superficially lamented as under-resourced and underfunded, yes, but certainly no serious plan or comment on how political factors and ideologies have contributed to its present condition.

There is little to be said by the BMA for how responsibility for welfare provision lay with government rather than individual doctors; virtually nothing on the role of austerity policies; and total silence on how neoliberal policies act as a system of corporate welfare, eliciting government action when in the direct interests of corporatism.

In place of safeguards demanded by the grassroots, there are instead vague quick-fixes. Indeed, there can be no protections for whistleblowers without recourse to definable and tested legal safeguards. There are limited incentives for compliance by employers because of atomised union representation and there can be no exposure of a failing system when workers are treated as passive objects requiring ever-greater regulation.

In many ways, the BMA exists as the archetypal “union for a union’s sake”, whose material and functional interest is largely self-intuitive. The preservation of the union as an entity is an end in itself.

Addressing conflict in a manner consistent with corporate and business frameworks, there remains at all times overarching emphasis on stability (“the BMA is the only union for doctors”), controlled compromise (“this is the best deal we can get”) and appeasement to “greater” interests (“think of the patients”). These are reiterated even when diametrically opposed to its own members or irrelevant to the trade dispute.

With great chutzpah, the BMA often moves from one impasse to the next, framing defeats as somehow in the interests of the membership. Channels of communication between hierarchy and members remain opaque, allowing decisions such as revocation of the democratic mandate for industrial action to be made with frightening informality.

Pointedly, although the BMA often appears to be doing nothing, the hierarchy is in fact continually defining the scope of choice available to members – silence equals facilitation and de facto acceptance of imposition. You don’t get a sense of cumulative unionism ready to inspire its members towards a swift and decisive victory.

The BMA has woefully wasted the potential for direct action. It has encouraged a passive and pessimistic malaise among its remaining membership and presided over the most spectacular failure of union representation in a generation.

Ahmed Wakas Khan is a junior doctor, freelance journalist and editorials lead at The Platform. He tweets @SireAhmed.