ARVAC Bulletin 101

The strange re-birth of co-production

Mary is 79 and lives in South East London. She has difficulty getting around, has no immediate family and lives alone. From one perspective, she typifies the people that so worry policy makers when they contemplate the future and its cohorts of aging baby-boomers. She is a drain on the public purse and presents a complex collection of problems for NHS health and social care services. But look a little closer, and the picture changes. As a member of the time bank at her local health centre, Mary has been exchanging her time with John, a 40-year-old recovering alcoholic, who lives in a hostel nearby. He tends her garden – and learns about plants and planting, guided by her years of experience – and she shares her wisdom and local knowledge with him on walks through the area.

Mary sees the difference in him, but he also knows he is changing too. “I didn't realise I had it in me, to take an interest in people, to be generous with my time with people,” he says. “I know this now because Mary showed me.” The value of feeling useful, when your main experience had been as a recipient of welfare service, can be transformative. The magic in this match is not hard to identify: they share a common experience as former civil servants, and a local time bank had the sense to match them up. But the real question is why we still need to define people in ways that can obscure the potential resources they represent for society around them.

Unfortunately government policy makers do not usually see it this way. While the Home Office is measuring voluntary activity in an unconnected kind of way, the Department for Work and Pensions is pushing a ‘full employment’ policy that threatens to strip neighbourhoods of the people who make the difference between success and failure in the public services – like volunteers, care workers and ‘co-producers’. That is one of the main messages that emerged from a new study into the concept of co-production – where service users are regarded as assets, involved in mutual support and the delivery of services.

The report, Hidden Work, is based on research led by the new economics foundation with the Gorbals Initiative, the South London & Maudsley NHS Trust and the Wales Institute for Community Currencies. The ‘hidden work’ of the title is neither voluntary nor paid, neither voluntary sector nor quite public sector either. It is carried out, below the radar of government – often alongside public services – checking on people when they come out of hospital, running community flats to keep down crime, adopting railways stations. Often it is carried out by people outside paid work, usually the clients of the same services being helped – broadening, deepening and injecting humanity back into the services they provide.

But policy makers do not see this. They discount this vital work: binding neighbourhoods together, helping local young people, caring or preventing crime and social breakdown, advising people with depression. They ignore it because it is done by public service, patients or welfare clients, and because the work is not paid. As a result, the people doing the hidden work will often be forced instead into inflexible, low paid work. In the spirit of co-production, the bulk of the research was carried out by people who were themselves outside paid work, who we trained up to carry out the interviews as researchers. We also rewarded them, not with money – which would have undermined their benefits status – but with time credits through local time banks, through which they could draw on neighbourly support if and when they needed it. It was intended also to give the lay researchers work experience and training which they could use later.

You might have thought government officials would welcome it, but they didn’t. One of the researchers actually lost their benefits as a result, and had serious difficulties because of the initiative he had taken. Never mind that he could have done similar training on an official course, and been encouraged to do so by officials. The fact that he had done this independently was a source of deep suspicion. We felt this was indicative of a wider malaise that – whatever the rhetoric – official bodies are designed to clamp down on signs of initiative, self-help or imagination among those who rely on them. They want their clients to be supplicants to their largesse and this is a major block to the emergence of a wider co-production movement – where public services transform themselves, broaden their services, by delivering those services in partnership with clients.

Yet there clearly is a growing co-production sector in Britain, though it is generally outside the remit of the nationally funded services that are supposed to be benefiting, and usually despite – rather than because of – administrative systems inside public services. They include time banks in the NHS, community support organised via the police, mutual food projects through organisations looking after asylum seekers – all of them done by, with and for the beneficiaries of these services, and making them broader and deeper as a result.

Can you define co-production, we asked ourselves? Probably not, but you can recognise it when you see it. Public services that are working in this way will usually:

• Provide opportunities for personal growth and development to people who have previously been treated as collective burdens on an overstretched system, rather than as potential assets;
  
• Invest in strategies which develop the emotional intelligence of people and capacity of local communities;
  
• Use peer support networks instead of professionals as the best means of transferring knowledge and capabilities;
  
• Reduce or blur the distinction between clients and recipients, and between producers and consumers of services, by reconfiguring the way services are developed and delivered: Services seem to be most effective here when people get to act in both roles – as providers as well as recipients;
  
• Allow public service agencies to become catalysts and facilitators rather than central providers themselves;
  
• Devolve real responsibility, leadership and authority to ‘users’, and encourage self-organisation rather than direction from above;
  
• Offer participants a range of incentives – mostly sourced from spare capacity elsewhere in the system – which help to embed the key elements of reciprocity and mutuality.

Those are partly a definition, but partly also a description of what public services will look like in the future, when they realise that their clients are assets they need to engage, not just supplicants they need to throughput.

David Boyle is an associate of the new economics foundation.

Hidden work: co-production by people outside paid employment (2005) is published by the Joseph Rowntree Foundation. Download for free from www.jrf.org.uk.