How Labour will give people the power to shape their own services

The trick is to understand where communities are at their strongest and most energetic and build capacity around them.

This week Ed Miliband and Jon Cruddas set out the purpose and mission of the next Labour government: "get power to give that power away". How we achieve it matters as much as our ambition to do it.

Boxed in between a market that sees us only as consumers and a state that is too often dehumanising and inflexible, it’s clear that change is long overdue. At a time when resources are scarce in the economy, they are abundant in our communities. Passion, energy, empathy and creativity exist in spades, if only we could see it.

But after four years of cuts which have placed the greatest strain on communities and families least able to bear it, the message that we’ll hand power to people to do things themselves may seem impossible to those who are struggling to stay afloat. They need to know that this is not "politics on the cheap". We recognise that some communities don’t currently have the time, resources or confidence to organise, challenge and create change. Last year research by Civil Exchange showed how, since the "big society", the most deprived areas of the country have fallen further and further behind. The "big society" was based on an entrepreneurial business model, where the state got out the way and communities thrived. The message from Civil Exchange is that they don’t - especially where help is most needed.

There is an inequality in people’s experiences of wielding power and changing this takes time. There are brilliant examples, like the Unicef Rights Respecting Schools Programme, which shares real power with children from the age of 5, allowing them to participate in shaping and running their own schools and learning by doing.

Investing in communities to help build their own capacity doesn’t mean bringing in clever people from Whitehall to set up forums and networks, as the government has done, on short-term contracts. From Wigan to Walsall, those relationships and community groups are already there. The trick is to understand where communities are at their strongest and most energetic and build capacity around them. In Wigan you might start with the grassroots sport clubs which are strong, thriving and have reach across local communities. It’s a big leap from running a football league to taking power back and using it to manage your own cancer care or shape your local health service and there are different ways of bridging it. One approach is through community organisers, like anti-fascist charity Hope Not Hate, which uses a network of grassroots organisers to build capacity to fight racism and fascism across communities.

There are other ways too. In Lambeth, the Young Lambeth Cooperative gives local people the power to make decisions about how their youth services are run. The budget is held in a community trust and services are commissioned by its members with support from the local Council. This is more than localism. Just as power can get stuck at national level, so too it can sometimes get stuck at local level. As Lambeth has shown, to give more power to people sometimes, you have to take it away from local and national government, or you have to push it downwards and give the frontline professionals tasked with helping people the power they need to do it. There are many people who need and deserve help and support to make decisions and manage their own care. Children in care, for example, frequently say decisions are taken without thought to the reality of their lives. They don’t want to make huge decisions by themselves; they want the support of an adult they trust. But just as they don’t currently hold power to make decisions, nor do their social workers. They need access to budgets across health and social care and real power to make decisions.

The lesson of these diverse examples is that they succeed because they recognise the colour and texture of life in different communities. Trying to impose one model squeezes the spirit and energy out of people and communities. As Jon Cruddas told the New  Local Government Network, our job is to help people shape things themselves in response to the needs of their own local communities.

This is so important because too often we hear people’s experience of both market and state is uncaring, unresponsive and inflexible, from incomprehensible computer-generated letters to poor service and lack of redress. Giving people the power and ability to shape services will stop us working in silos, ticking boxes and ignoring the things that matter to people most. Business developments that take no account of the wider impact on the community, a care system that drives a coach and horses through the relationships that sustain children at the time they need them most. The answer is to give children-in-care councils, patient forums and residents associations the power and ability to shape those services around the things that matter to them.

It’s not easy to do but it couldn’t matter more because it’s built on the idea of human potential, replacing a deficit model which focuses on people’s problems with a positive model which focuses on people’s potential.

Lisa Nandy is shadow for minister for civil society and MP for Wigan

Ed Miliband delivering his speech on banking reform at the University of London last month. Photograph: Getty Images.

Lisa Nandy is the MP for Wigan. She was formerly Shadow Secretary of State for Energy and Climate Change.

Getty
Show Hide image

A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear