Book Review: Radical Help, by Hilary Cottam

November 23, 2018

     By Duncan Green     

Every now and then a conversation, paper or book reminds me that activists in the UK are out there in their  thousands, often working and thinking along parallel lines to their counterparts in Oxfam and around the world. I just finished Radical Help, a wonderful book by Hilary Cottam, for which the tl;dr summary could be ‘Amartya Sen meets the Welfare State, and tells it to pull its socks up.’

70 years after its glorious beginnings, the UK welfare state is creaking. The problems run far deeper than austerity (although that matters too). It faces social challenges it was not designed for (obesity, precarious work, ageing); there is a crisis of care (ageing, changing roles in the family) and poverty endures as inequality rises.

The welfare state was built around a series of assumptions and ways of working: it fills gaps, the sick can be cured by medical intervention (what about Alzheimers? Obesity?), society is made up of individuals whose problems can be fixed through individual interventions (what about relationships/social capital?).

Cottam believes that the move to ‘New Public Management’ took these original design flaws and made them far worse. ‘We have normalised the idea that for every problem there must be a service’, and given budget constraints and politics, those services are expected to be delivered ever-more cheaply.

Interestingly, the architect of the UK welfare state, William Beveridge, was by 1946 already growing concerned about its direction. He published a third report on voluntary action, in which he voiced concern that he had both missed and limited the power of the citizen and of communities.

Which is where Amartya Sen comes in. Cottam bases her ideas for a revamp of the welfare state on his ideas of capabilities and agency. ‘Our welfare state might still catch us when we fall, but it cannot help us take flight.’ What assets do people have? What do they want to do with their lives (often as families or communities)? Start from there, instead of the individualised ‘culture of lack’.

So far, so rhetorical, but Cottam is a one-woman think-and-do tank, so she rolled up her sleeves and started trying to test her ideas in practice, via Participle, an organization she founded. Most of the book is devoted to an account of five experiments, developing new prototypes for working with families, teenagers, the unemployed, chronically sick and the elderly, building on their assets and desires. The accounts are full of moving stories of the people she encountered and worked with (no space here, because I know that geeky FP2P readers will be clamouring for the methodology, but they really are very good).

On what look like pretty limited budgets (she doesn’t provide details), Participle developed a set of principles and a design methodology for coming up with new and innovative approaches. They include developing a vision and recovering a sense of purpose (sorely missing from large parts of the modern welfare state); supporting people to grow their capabilities, starting with learning, health, community and relationships (of these, relationships often hold the key to progress on the other 3). Create a sense of possibility in the people you are working with and they will often take it from there.

To put these principles into practice, Participle adapted design thinking, spending lots of time understanding the context and framing the problem/finding the opportunity. That meant finding funding champions (usually local authority leaders willing to take a risk) and putting together a core team. Then came drinking lots of cups of tea on sofas in deprived areas of Britain, getting to know people, and starting to understand from the inside their lives, aspirations and the root causes of their problems, a process she likens to an ‘archaeological dig’.

That process of immersion generates ideas, which are tested with quick and dirty prototypes – a music group where a manager of some sheltered flats plays Frank Sinatra over the phone to lonely but music-loving Stan and other residents. Then tweak and scale up, using the prototype to try and raise the necessary funding.

So how does this compare to the kind of stuff I read every week on innovation in aid and development? The approach has echoes of Adaptive Management and participatory methods, but Cottam is a lot more concerned with the emotional world – loneliness, dependency, relationships, kindness – a serious gap in a lot of the thinking and practice on development.

Considering this is a book about rebuilding individual and community agency, the state still plays a huge and central role in Cottam’s world. No other institutions (faith groups, sports, arts organizations) seem to exist in these communities, which seems odd, given her emphasis on relationships and social capital. As well as humanising the welfare state, why not try and diversify the relationships and networks that support people and communities?

The style grates at times – this is an unashamed sales pitch for a new idea. Victories are numerous and save bucket loads of money; defeats are temporary set-backs; opponents are knaves or fools.

She waves away concerns about whether any of these approaches can go to scale on fairly flimsy grounds.

And you won’t be surprised to hear that I found her theory of change/action a bit weak. She is good on the blockers (ideas, institutions, interests) that stop her approach spreading, but apart from praising local champions in places like Swindon and Wigan, she doesn’t seem to have any suggestions of what might bring about the changes she seeks (other than publicising her undoubted successes). The original welfare state required a World War to bring it about – what will this kind of overhaul need?

But these are minor gripes – the book is great, and has made me think differently about the challenges facing the UK. I hope it does the same for others.

And here’s her much-watched TED talk on the issue