Archive for the 'Social Policy' Category

‘Ain’t no such things as half-way crooks’: political discourses and structural duplicity in the troubled families agenda

Troublemakers FC

‘Troublemakers’ by Stephen Crossley came out in April

Stephen Crossley, author of Troublemakers: The construction of ‘troubled families’ as a social problemdiscusses the National evaluation of the Troubled Families Programme 2015 to 2020 interim findings, ‘dirty data’, his approach and methodology and the purpose of academic research.

Academics from different disciplines are often expected to demonstrate the impact of their research and this impact can be expected to relate to demonstrable changes in policy and/or practice. Such aims can lead to research being commissioned and published that is amenable to the interests of policy-makers and politicians. But there can be dangers in this, especially in the UK at the current time where many academics would not feel comfortable aligning themselves with some of the policies being pursued or advocated by our government or other powerful institutions.

The French sociologist Pierre Bourdieu railed against ‘lackey intellectuals’ (Stabile and Morooka, 2010: 329) who put themselves in the service of neoliberal governments and, along with his long-time collaborator Loïc Wacquant, referred to such individuals as ‘defector[s] from the academic world entered into the service of the dominant, whose mission is to give an academic veneer to the political projects of the new state and business nobility’ (Bourdieu and Wacquant, 2001: 1).

“Sociology should not be a ‘disinterested calling pursued for purely intellectual and aesthetic reasons’ and instead should be ‘committed to, and involved in, solving current problems’”

In studying the implementation of the Troubled Families Programme (TFP) for my PhD and for Troublemakers, I wanted to adopt a different approach. Drawing on the work of Bourdieu and Wacquant, as well as other sociologists who have urged researchers to remember whose side they are on and to ‘study up’, I decided that ‘muckraking’ sociological approach would be appropriate. Gary T. Marx argued for a ‘muckraking sociology’ which, using the tools of social science, could help to unearth ‘dirty data’. Marx, like many others, proposed that sociology should not be a ‘disinterested calling pursued for purely intellectual and aesthetic reasons’ and instead should be ‘committed to, and involved in, solving current problems’ (1972: 4).

Writing in the 1970s, but with continuing relevance, he argued that muckraking research should help to document and publicise ‘the gap between values and actual practices and in questioning established orthodoxies’ (Marx, 1972: 2), and could be of benefit to those groups seeking change. Such research, Marx argued, could ‘give us a clearer picture of our world, stripped of protective verbiage and without the usual selective perceptions (and misperceptions)’ (1972: 4–5). In a passage particularly relevant to an examination of the TFP and its emphasis on ‘hands-on’ practical support for disadvantaged families, while marginalising structural inequalities and poverty, Marx argued that muckraking research ‘can expose the fallacies in certain common sense beliefs about social problems and show how certain ideas rationalize an unsatisfactory status quo’ (1972: 5) He goes on suggest that:

Such research uses the tools of social science to document unintended (or officially unacknowledged) consequences of social action, inequality, poverty, racism, exploitation, opportunism, neglect, denial of dignity, hypocrisy, inconsistency, manipulation, wasted resources and the displacement of an organization’s stated goals in favour of self-perpetuation. It may show how, and the extent to which, a dominant or more powerful class, race, group or stratum takes advantage of, misuses, mistreats, or ignores a subordinate group, often in the face of an ideology that claims it does exactly the opposite.

Such an approach has been particularly fruitful in studying the TFP. Research by myself and other academics have unearthed a large amount of ‘dirty data’ relating to the programme ‘whose revelation would be discrediting or costly’ to the government and that goes beyond incidental or minor inconsistencies, errors of judgement or ‘soft-core discrepancies’ (Marx, 1984: 79).

“The government claimed to have evidence that there were 120,000 ‘troubled families characterised by crime, anti-social behaviour, school exclusion and ‘worklessness’. It didn’t.”

In 2011, at the launch of the programme, the government claimed to have evidence that there were 120,000 ‘troubled families characterised by crime, anti-social behaviour, school exclusion and ‘worklessness’. It didn’t.

It had evidence that, around seven years earlier, there were around 120,000 families that were experiencing ‘multiple disadvantages’ such as poverty, material deprivation, poor housing, and poor maternal mental health. The government claimed that the programme ‘turned around’ the lives of 99% of the 120,000 ‘troubled families it originally set out to work with. It didn’t.

Families that turned themselves around with no contact with the programme were counted in the TFP figures. Families could, in some circumstances, be classed as having been ‘turned around’ by a child reaching school leaving age. The effectiveness of the ‘family intervention’ model, on which the TFP is based, had, in the words of David Gregg, been ‘sexed up’. Research was carried out without appropriate ethical procedures. Statistics and surveys that formed the basis of the need for ‘radical reform’ were invented. Local authorities were effectively threatened with naming and shaming if they didn’t ‘turn around’ 100% of their families in the first phase of the project. Local authority officers on the programme complained of staff from DCLG phoning them up to complain about slow progress. It was alleged that the government attempted to ‘suppress’ the official evaluation of the programme when it failed to provide them with the support it was expecting. Researchers who critiqued the programme had their competence and their integrity publicly called into question. A parliamentary committee accused the DCLG (now the Ministry of Housing, Communities and Local Government) of obfuscation and evasion in its lack of co-operation with an inquiry into the programme.

While I was carrying out my research, I was reminded of Mobb Deep’s assertion that there ‘aint’ no such things as half-way crooks’. In more academic terms, Bourdieu (1985: 738) argued that ‘political discourses have a sort of structural duplicity’, and the ‘troubled families’ agenda is a clear-cut example of this. It relies on deceit and duplicity at all levels, and the catalogue of inconsistencies, contradictions and falsehoods listed above cannot be put down to individual errors of judgement or mere coincidence.

Troublemakers focuses attempts to explicate and lay bare the overblown claims of the programme, the underhandedness, political chicanery and ‘structural duplicity’ that has been evident throughout the programme, and the symbolical importance of the programme at a time of wider state restructuring. It is, in short, an attempt to rake all, or as much as possible in a little over 200 pages, of the muck associated with the TFP into a single heap.

References

Bourdieu, P. and Wacquant, L. (2001) NewLiberalSpeak: Notes on the new planetary vulgate, Radical Philosophy, 105: 2-5.

Marx, G.T. (1972) (ed.) Muckraking Sociology: Research as Social Criticism, New Brunswick, NJ: Transaction Books.

Stabile, C.A. and Morooka, J. (2010) ‘Between Two Evils, I Refuse To Choose The Lesser’, Cultural Studies, 17 (3-4): 326-348.

Troublemakers FCTroublemakers by Stephen Crossley is available with 20% discount on the Policy Press website. Order here for £19.99.

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Repealed! Now we look to Northern Ireland

Judith-head-shot-Oct-17-cropped

Judith Orr

Originally published by the Abortion Rights blog on May 26th 2018.

An uprising of activists in every city, town and village across Ireland made history yesterday and sealed the end of an era that saw women denied basic human rights. The victory of the Repeal the Eighth campaign will ring out across the world to everyone who is fighting to win the right to safe and legal abortions, whether in Poland, Bolivia or even on the doorstep, in my own birthplace, Northern Ireland.

The grassroots campaign saw great teams of people knocking on doors night after night and taking stalls to local high streets all over the country. It was inspiring to witness thousands of people going out to talk to people face to face about why they should vote Yes.

Thousands came #HometoVote from all over the world, and numerous Twitter streams and new hashtags showed the reach and creativity of the movement. Dentists for Yes campaigned in tribute to Savita Halappanavar who died in 2012 after she was denied an abortion when she suffered a septic miscarriage. She was herself a dentist, and her parents spoke out from India in support of a yes vote. Farmers for Yes tweeted photos of themselves holding Yes signs alongside their livestock and tractors while Grandfathers for Yes defied the clichés that this was simply a generational divide.

“…while Grandfathers for Yes defied the clichés that this was simply a generational divide.”

But most of all the courage of all those who told their own personal stories, many for the first time, stands as a testament to the cruelty of a state ban of what is an essential part of women’s health care. Moving accounts, for example on In her Shoes Twitter account, recorded the anguish inflicted on women who had to travel to end an unwanted pregnancy, or who needed to end a wanted pregnancy for health reasons. Women spoke out about the past so no one would have to go through what they endured in the future.

The No side showed no humility in the face of this outpouring of moving experiences. In fact the anti abortion lobby rehearsed its well worn propaganda about being ‘pro-women’ and ‘pro-life’. These claims were exposed as being lies as the Yes campaign highlighted the impact that denying access to abortion services in Ireland had on every area of women’s health care.

Women described being denied cancer treatment, or medication for epilepsy, when they became pregnant. One doctor told of woman brought by ambulance to a maternity hospital rather than an A&E after being injured in a car accident because she was pregnant. Her own physical injuries were dealt with only after doctors successfully picked up the foetal heartbeat. In the most tragic cases surviving relatives bore witness to the consequences of the constitution treating a foetus and a pregnant women as equal under the law

So this is a momentous change that has been a long time coming. Many compare yesterday’s referendum to one that led Ireland to be the first country to legalise equal marriage after a poplar vote in a referendum. But although both show how attitudes to the Catholic Church’s orthodoxies are changing, today’s result is even more significant. Women’s lives, their bodies, their fertility and sexuality have always faced the greatest scrutiny by the church and the establishment.

“Abortion cannot be seen in isolation, rather as part of a regime of oppression that imposed severe restrictions on women’s lives, and on their sex lives in particular.”

Abortion cannot be seen in isolation, rather as part of a regime of oppression that imposed severe restrictions on women’s lives, and on their sex lives in particular. This is a system that saw women who did give birth, but who happened to be unmarried, forced into institutions, such as Mother and Baby homes and Magdalene laundries. Here their babies were forcibly taken from them to be adopted. Many babies were even sold, often to rich American couples, leaving a trail of personal devastation over generations.

The discovery, in 2017, of a mass grave of babies and children in the grounds of a former Bon Secours Mother and Baby home in Tuam, County Galway show that the full truth of these institutions has yet to come out.

This policing of women’s bodies meant that some women were shamed if they did give birth, but others were also shamed if they decided they did not want to continue a pregnancy. Yet, as so many Yes campaigners pointed out, keeping abortion illegal did not stop Irish women having abortions, it just stopped them having abortions in Ireland.

Yet the shame associated with abortion is not unique to Ireland. Abortion still carries a stigma in countries with access to legal abortion, such as Britain. Abortion is portrayed as the ultimate betrayal of what it is to be a woman, we are encouraged to see it as an aberration and a rejection of our natural biological selves. When anti abortion campaigners can’t win a bar on abortion they concentrate on maintaining these taboos.

Such stigma will not disappear overnight, but the impact of what has happened in Ireland cannot be overstated. It is a sea change that will not only affect the legal status of abortion. The result is both an expression of, and spur for, a transformation of social attitudes to abortion as well. This will be the backdrop for the debates still to come over what new abortion legislation will say, and then about how that is interpreted and implemented.

“But there is also other unfinished business that is thrust into the spotlight by the referendum result, and that is the ban on abortion rights in Northern Ireland. “

But there is also other unfinished business that is thrust into the spotlight by the referendum result, and that is the ban on abortion rights in Northern Ireland. The 1967 Abortion Act was never extended to Northern Ireland, last year least 700 women traveled to England for health care they should be able to access at home. Others risk prison sentences by buying abortion pills online. One woman, 19 years old when she bought online pills when she couldn’t afford to travel to England, received a three month suspended sentence in 2016.

Theresa May was forced to concede that women from Northern Ireland should have access to NHS funded abortions in England in 2017. Until then women from Northern Ireland, paying the same National Insurance and taxes as women in the rest of the UK, not only had to travel for abortion care, they also had to pay for it privately. The issue threatened May’s ability to form a government after a snap election in June left her without a Tory majority. Her subsequent deal with the DUP, a Northern Ireland party trenchantly opposed to abortion rights, led Labour MP Stella Creasy to put a widely-supported amendment that could have defeated May’s critical Queens Speech.

In a single afternoon 50 years of discriminatory practice was overturned. This was not a sudden change of heart by the Tory government wanting to put right half a century of injustice. Health Secretary Jeremy Hunt had only two weeks earlier fought a case in the Supreme Court to defend the right to deny NHS funded abortions to women from Northern Ireland.

This was a reform pushed through by a government to ensure its own survival, but it showed what was possible. It has made a real difference for hundreds of women. But they still have to travel, and many cannot take the trip even if it is funded, for many different reasons from ill health to child care or the fact they are living in an abusive relationship.

That’s why today while we are celebrating this tremendous referendum victory, the Abortion Rights campaign in the UK is saying let’s take this opportunity to demand reproductive rights for women in Northern Ireland too. It’s about time.

final FC_Lyn 4 webAbortion wars by Judith Orr is available with 20% discount on the Policy Press website. Order here for just £10.39.

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Conceptual issues in welfare debates

Exploring welfare debates [FC] rgb

Exploring welfare debates is out this week!

Lee Gregory, author of Exploring welfare debates, publishing this week, discusses the ideological and conceptual issues surrounding welfare debates.

This new textbook provides an introduction to key concepts and debates in welfare using an innovative, question-based narrative to highlight the importance of theory to understanding welfare.

There is a companion website available here.

Our daily lives are surrounded by injustices. Homelessness, poverty, destitution, health inequalities, the list can go on. If you’re a student of social policy or any social science subject you are likely angry at the injustices you see and want to do something to change them, to remove them from existence. That is exactly how I felt.

Studying sociology, politics, law, psychology during a BTEC in Public Services (I was hoping to be an Ambulance Paramedic) my desire to help people started to change. For me there was something fundamentally wrong with how society was structured if it left people destitute, hungry or homeless. If where you were born influenced how long you lived then there was a need for change. But I didn’t feel that I could find a way to pursue this until I discovered Social Policy. It was a fluke, a passing comment by a lecturer at my college, a quick read of Alcock’s Social Policy in Britain and I knew I had found what I was unknowingly looking for.

Poverty, inequality and stratification where my initial interests but I soon discovered that underpinning this, and every other social problem, are a series of debates about the nature of the problem and the appropriate solution. And this isn’t just ideological, it’s conceptual.

“I understand now that these problems exist because we cannot agree on the nature of the problem and the solution.”

This is why concepts have become such an integral part of my thinking, research and teaching. In Foundations of the Welfare State, Briggs (1984: 1) states ‘There was no single impulse behind the making of the welfare state’: rather there are multiple. Exploring conceptual debates in relation to welfare allows us to explore a combination of these impulses: need, citizenship, equality, stigma, social control, and globalisation.

What is fascinating about concepts however is that they are not static. There is no one concept of need which underpins all welfare debates, there are several. The task therefore is to consider how you define need and how you can identify and justify this definition with a longer historical debate. This is what fascinated me. Why, if we have the evidence that, for example, if 14m people live in poverty in the UK, more than 800m globally are in extreme poverty, and, according to FEANTSA, the European Federation of National Organisations Working with the homeless, homelessness is on the increase across Europe (except in Finland), do these social problems persist? That younger version of me was both fascinated and frustrated, surely this shouldn’t be? I still am both fascinated and frustrated but I understand now that these problems exist because we cannot agree on the nature of the problem and the solution.

“By exploring welfare debates you can start to understand other views, as well as your own and find the conceptual language for arguing in favour of the change you wish to pursue”

This is not just an ideological debate, but also conceptual. How we define need, equality and social rights, for example, shape how we respond to social problems. Whether we think a particular problem is something the state should be actively eradicating or if we need to rely upon other mechanisms in the market or voluntary sector.

Just as there are many reasons for developing a welfare state, there are different ideas about how we respond to welfare. Understanding these ideas, or concepts, is the essential starting point for studying social policy and for changing the world we live in.

For new students to social policy, however, these can be unsettling discussions. We all come to our studies with some exposure and experience of different insights, debates and views of social problems. But social policy requires that you develop a broader understanding. By exploring welfare debates you can start to understand other views, as well as your own and find the conceptual language for arguing in favour of the change you wish to pursue to tackle injustices and to remake the world around us. Concepts are just one of a number of tools you need to make change, but they are the starting point.

 

Exploring welfare debates [FC] rgb

 

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Roma in a time of paradigm shift and chaos

 

authos

Andrew Ryder and Marius Taba

A themed section of the Journal of Poverty and Social Justice ‘Roma in a Time of Paradigm Shift and Chaos’ is available online and will be officially launched on 19 April 2018 in Budapest.

Here Andrew Ryder and Marius Taba explain how this themed section of the journal explores ideas around Roma communities in times of austerity and change.

“The financial crisis of 2008 created a monumental process of turbulence and dislocation in not only economic structures but also in the fields of politics and culture. Nearly ten years after the financial crisis many of the causal factors and consequences of that crisis have not been solved with Roma among the groups most damagingly affected.

This themed section of the Journal of Poverty and Social Justice explores notions such as securitisation and how political elites are using the Roma to frame monocultural and xenophobic visions of society. Such trends are leading to the fragmention of the social contract and framing of the Roma in a moral underclass discourse leading to cuts in welfare, workfare programmes and pushing Roma communities further into precarious economic activities. Growing poverty leads to isolated and ghettoised Roma communities which in tandem with racism creates segregated schools and low participation and attainment. These economic drivers in exclusion and segregation have been accentuated by welfare cuts and economic downsizing prompted by recent austerity drives in the wake of the global financial crisis.

“…the themed section considers how the Roma might fare under bolder, redistributive and interventionist policies by the state and the potential of critical forms of multiculturalism.”

As well as detailing the negative impacts of such societal trends on the Roma, the themed section considers how the Roma might fare under bolder, redistributive and interventionist policies by the state and the potential of critical forms of multiculturalism. The themed section explores a number of different questions, as follows:

How might EU policy be reorientated to raise the inclusion of Roma communities? How might the concept of a Social Europe impact upon EU policy and Roma communities? 

The EU Framework for National Roma Integration Strategies (NRIS) was launched in 2011 by the European Commission. The Framework is based on open method coordination and EU member states are expected to devise National Roma Integration Strategies, which address exclusion in the spheres of employment, health, education and accommodation. Critics claim Roma civil society has either been ignored in the formulation of national action plans or has been accorded a tokenistic say in design and delivery. Moreover, targets have been weak or limited. The European Roma Rights Centre in 2016 concluded “Five years on, the EU Framework has hit ’a mid-life crisis’. The NRIS have yet to deliver in terms of concrete change to the lives of millions of Europe’s Romani citizens; the implementation gap is more pronounced than ever; discrimination and segregation remain pervasive and human rights abuses against Roma are all too frequent”.  Critics have argued though that open method coordination, upon which the NRIS is based, supports neoliberal tendencies as its emphasis on dialogue and flexibility deters bolder actions.

What might the implications be if the EU project were to fragment and unravel? 

The European project appears to be in jeopardy with critics questioning its relevance with those on the right of the political spectrum wishing to see a focus on market rather than social matters, and questioning the degree and level of European integration. Recently such sentiments led to the UK electorate opting in a referendum to leave the EU. There are fears that other countries may emulate the UK or that it will bolster those who wish to see the EU reduce its social dimension.

How grounded are new trends in Roma Identity?

Within Roma communities important questions and new directions have emerged in the performance and articulation of identity. Whilst poverty and xenophobia have led to Roma communities accentuating tradition through bonding networks others have taken radical departures as reflected by the growing Roma LGBT and feminist movement.

Is the ’Roma Awakening’, a growing cadre of Roma scholars emerging within the academy who are challenging the positivism of the established academic establishment, some of whom support a European Roma Institute to counter anti Gypsyism, merely a reflection of narrow identity politics and the emergence of a new Roma elite or does it present a fundamental shift in knowledge production and Roma empowerment?

Kuhn (1962) described as a paradigm shift, a situation where the anomalies of an established and dominant paradigm are exposed through critique and seeming inability to meet present challenges. On occasion and in the absence of credible responses, there can appear a crisis of confidence in the now vulnerable paradigm (revolutionary phase); if unable to adapt, the old paradigm is consequently replaced with a new conceptual world view, which for a period of time is sovereign in its assumptions, at least until the cycle repeats itself. The emerging paradigm takes as its starting point the theorisation of ethnic and intersectional oppression.

Given the economic and political challenges confronting Europe Roma civil society may be facing its greatest ever test.”

The themed section also asks: How effective has Roma civil society been in promoting social justice and how has it fared as a consequence of austerity and contracting funding bases, alongside heavy dependence on a few donors?

Critics have highlighted fears of a ‘Gypsy industry’ where civil society offers narrow, outsider-driven and ill thought-out initiatives. However, a dynamic civil society can play a critical role in empowering communities, and shaping policy and forming the bedrock of effective national and European advocacy campaigns, by ensuring that advocacy is grounded in the needs and aspirations of communities. Despite the weaknesses of Roma civil society it has often provided the training grounds and platforms for the handful of younger progressive Roma lawmakers, activists, thinkers and artists that are now taking the political and cultural stage. Given the economic and political challenges confronting Europe Roma civil society may be facing its greatest ever test.

 

JPSJ_OFC_Feb2016_72.THINBORDERExplore the themed section: ‘Roma in a Time of Paradigm Shift and Chaos’ from the Journal of Poverty and Social Justice:

Introduction: Roma in a time of paradigm shift and chaos
Author: Matache, Margareta

Roma and a Social Europe: the role of redistribution, intervention and emancipatory politics
Authors: Ryder, Andrew Richard; Taba, Marius

Gender, ethnicity and activism: ‘the miracle is when we don’t give up…’
Authors: Daróczi, Anna; Kóczé, Angéla; Jovanovic, Jelena; Cemlyn, Sarah Judith; Vajda, Violeta; Kurtić, Vera; Serban, Alina; Smith, Lisa

Blame and fear: Roma in the UK in a changing Europe
Authors: Richardson, Joanna; Codona, Janie

Policy & Practice: EU policy and Roma integration (2010–14)
Author: Andor, László

The Troubled Families Programme: changing everything, yet changing nothing

 

Troublemakers FC

‘Troublemakers’ is out now

Stephen Crossley, author of Troublemakers: The construction of ‘troubled families’ as a social problem – out today – examines the most recent Troubled Families Programme Outcomes report, which published last week.

 

The Evolution of the Trouble Families Programme

The Troubled Families Programme (TFP), originally tasked with ‘turning around’ the lives of 120,000 ‘troubled families’ in a single term of parliament has evolved into a different type of programme since its inception, albeit one with many enduring features. The expanded criteria for the second phase of the TFP shifted from allegedly criminal, anti-social and ‘workless’ families, to include those experiencing troubles such as domestic violence and health issues.

The ‘next phase’ of the programme, announced in April 2017, sought to bring sharper focus to the work of the TFP by emphasising the need to support ‘workless’ families into employment. The criteria for identifying and prioritising families for the programme changed, the outcomes expected by the programme also shifted, but some core, sometimes unintentional, features of the programme remain, including the labelling of disadvantaged families as ‘troubled’.

 

Disproving the ‘underclass’ theory

The most recent findings, published on 27th March, highlight some continuities with previous ‘troubled families’ publications.

“Fewer than 10% of ‘troubled families’ were involved with one or more anti-social behaviour incidents in the twelve months prior to entering the programme”

By way of example, we learn from the latest Outcomes report that:

  • Fewer than 10% of ‘troubled families’ were involved with one or more anti-social behaviour incidents in the twelve months prior to entering the programme (p24);
  • Only one in three ‘troubled families’ are classed as ‘workless’ (p20);
  • Fewer than 2% of ‘troubled families’ had ever been evicted (p21);
  • and just 2.8% of children in ‘troubled families’ had a caution in the 12 months prior to entering the programme.

The findings thus mirror two sets of evaluation data from the first phase of the programme (Final report on the family monitoring data and An interim report showing family monitoring data), and demonstrate that the stigmatising feckless, workshy, ‘neighbours from hell’ imagery associated with ‘troubled families’ courtesy of powerful individuals such as David Cameron, Eric Pickles and Louise Casey, is entirely inappropriate. Essentially, the official evaluation of the TFP is the latest in a long line of research that helps to disprove the longstanding theory of an ‘underclass’.

 

Changing nothing

The impact of the programme also continues to look problematic, considering this was a flagship social policy that was originally intended to ‘turn around’ the lives of ‘troubled families’ and change the way that the government intervened in their lives.

The impact study of the first phase of the programme was ‘unable to find consistent evidence’ that the programme ‘had any significant or systematic impact’ (p20). Since the renewed focus on tackling ‘worklessness’ was announced in April 2017, 104,809 families were worked with on the programme. Of these, just 4,807 families entered ‘continuous employment’ in the last year. In just under three years, not a single ‘troubled family’ in Newham (out of 2858 on the programme) has met the ‘continuous employment’ criteria according to the latest figures. And yet, over a slightly longer period, over 1000 families met this criteria in Liverpool. The difference between such figures (and there are plenty of other inconsistencies) is not explained.

The main finding in the Outcomes report is that a significantly smaller proportion of children were classed as children in need (a 3.9 percentage point difference, a statistically significant difference) after 6-12 months of work under the TFP, than similar families in a matched comparison groups who were not on the programme over a similar period. This improvement is to be welcomed, but given the resources allegedly attached to the TFP, the intensive, transformative approach, and the allegedly failing approach of other services, it hardly represents conclusive evidence that the family intervention model is worth the effort.

 

Deflection

The continuing focus on ‘families’ – either ‘troubled’ or ‘workless’ – and on the family intervention approach continues to deflect attention away from the quantity and quality of jobs on offer, and their suitability or otherwise for carers of young children and/or disabled or vulnerable adults. The potential consequences of poor, or insecure, or sporadic work on disadvantaged families’ lives remained undiscussed. Poor quality, poorly paid, irregular work, often at unsociable hours in the early morning or late at night, accompanied by potential or changes to benefits entitlements, does not always lead to less parental conflict, more support for ‘children in need’, or a greater, more sustainable income. The pejorative term ‘workless’ ignores the amount of domestic and caring work that takes place within ‘troubled families’, many of whom have young children and/or family members with health issues or disabilities.

“The transformation of local services that the government claims is taking place under the TFP appears to be driven more by ideology than evidence.”

 

Ideology not evidence

Despite the evidence that suggests a lack of impact in many areas, there also remains claims of the allegedly transformative aims of the TFP. As each phase of the programme has been announced, and as its profile and importance has dropped, there has been an increase in the extent to which the programme claims to be transforming and re-shaping local services. The most recent annual report claims that the programme ‘drives service reform’, ‘drives reduction in social care demand’ and ‘promotes social justice’. Problematic and/or slow progress of many families on the programme suggests that the family intervention approach might not be worth ‘rolling out’ and ‘mainstreaming’. The transformation of local services that the government claims is taking place under the TFP appears to be driven more by ideology than evidence.

 

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Shared Lives: a new health and care system

Alex

Alex Fox

Alex Fox is the author of A new health and care system – out today and launching at Nesta this evening.

Here he unpicks the dehumanising tendencies of our public services to introduce a new health care model where those living with long-term conditions can achieve wellbeing in a system that looks at people’s strengths and capabilities, and their potential, not just their needs.

“The NHS was designed in the 1940s for brief encounters: healing us or fixing us up. It often does that astonishingly well. But now 15 million of us (most of us at some point during our lives) live with long-term conditions; three million with multiple long-term conditions. We cannot be healed or fixed, we can only live well, drawing on state support relatively little, or live badly, drawing on state support heavily and falling repeatedly into crisis. That long term, increasing reliance on intensive support services is not only likely to feel miserable to us as individuals and families, it drives long term financial meltdown which will bankrupt our service economies, even if they survive the current period of austerity.

“…we remain locked into seeing people who need support as illnesses, impairments, problems, risks, not as people who can and must share at least some of the responsibility for their own wellbeing.”

So we need a different relationship between people with long term conditions, their families and the services they turn to for help. But health and care leaders continue to talk and plan as if the health and care system was fixable by streamlining what we currently do, integrating various kinds of organisation, or making better use of tech. This is because, whether we use public services, work in them, or lead them, we remain locked into seeing people who need support as illnesses, impairments, problems, risks, not as people who can and must share at least some of the responsibility for their own wellbeing. We do not recognise that people who live for years or decades can become more expert in what works for their wellbeing than many of the professionals who necessarily dip in and out of their lives. Family carers provide more care than the state, but even they are not recognised as vital members of a wider caring team, who might need knowledge, training, equipment and emergency back up just as much as their paid colleagues.

“…fit support around a good life instead of asking people to fit their lives around a good service.”

To unpick this, we need to trace the dehumanising tendencies of our public services from their first contact with people who may need their support and their families, through all of their interactions, to the ways in which they ultimately reject, or in some cases, cling on to, their inmates. With demand rising, services are putting more resources into assessment processes designed to keep away the less needy, but those processes are themselves a drain on resources, and they ensure that those who meet needs thresholds are least able to identify and build on their own capacity to self-care, and have already had their confidence and independence demeaned and undermined by bureaucracy.

The alternative is to take an ‘asset-based’ approach to every long-term support service offered: looking for people’s strengths and capabilities, and their potential, not just their needs. For nearly everyone, these ‘assets’ are partly their relationships with friends and families, so every support service must be delivered in ways which fit round and back up those informal networks, minimising disruption to them.

There is already at least one nationally scaled support model which does this: Shared Lives, now used by 14,000 people in almost every UK area.

Edward, Stephen and Christina’s story

edward-2

Edward is 66 years old and lives with Shared Lives carers Stephen and Christina. Edward has a learning disability and has been blind since childhood, and when living with traditional methods of support his independence suffered. He didn’t have his own space and was restricted from carrying out many of the tasks and routines of daily life, as well as access to broader life experiences.

Stephen had had contact with Edward through his previous work as a social worker. He perceived that Edward had a lot of potential and believed he could do much more for himself. So when Stephen became a Shared Lives carer and developed his own personal care skills, he and Christina opened their home to Edward and made it their mission to develop his confidence.

The transformation has been profound, with Edward describing his increased independence: “I’ve got my own room and all the things I need. It’s been brilliant. I haven’t looked back since I’ve been with Stephen and Christine.”

Edward has gone from a situation in which he hardly ever experienced leisure activities or life outside home, to having an impressive list of holidays and trips under his belt. He has been to Las Vegas, and taken a helicopter ride over the Grand Canyon. Closer to home, with a bit of support from his Shared Lives carers, he has been to a Formula One Race at Silverstone: “I could feel the cars!” said Edward, describing the sensation of picking up the vibrations of the revving of engines through his feet.

Stephen has encouraged Edward’s enjoyment of the atmosphere at sporting events – and they go to the rugby almost every week. Through Shared Lives, Edward has been able to explore his pre-exiting interests in cars and sports to the full.

Shared Lives demonstrates that it is possible to combine people’s own capacity, with the strengths of positive family and community life, and the back-up and resources of a regulated care service. No one approach can be the magic bullet which will heal our ailing NHS, but Shared Lives offers lessons and challenges which could be taken up by any service: look for the person, not the condition; fit support around a good life instead of asking people to fit their lives around a good service; always connect.

A new health and care system [FC]A new health and care system, by Alex Fox is publishing on 28 February 2018 and is available with 20% discount on the Policy Press website. Order here for just £15.19.

Find out more about impact, influence and engagement at Policy Press here.

Policy Press newsletter subscribers receive a 35% discount – sign up here.

The views and opinions expressed on this blog site are solely those of the original blog post authors and other contributors. These views and opinions do not necessarily represent those of the Policy Press and/or any/all contributors to this site.

Repealing the 8th: how new legislation on abortion should be designed

Fiona de Londras

Fiona de Londras

Mairead Enright

Mairead Enright

Fiona de Londras and Mairead Enright – authors of ‘Repealing the 8th: Reforming Irish abortion law‘ – respond to the announcement of the Irish Cabinet of its intention to hold a referendum to repeal Article 40.3.3 in May 2018. The book, now publishing on Thursday this week, looks beyond the referendum to what might come next, presenting detailed proposals for new legislation.

Chapter 4 from the book – Accessing abortion care: principles for legislative design – is now available to download free on our website. 

In 1983 the Irish Constitution was amended by the insertion of Article 40.3.3, now known as ‘the 8th Amendment’. This provides that “the State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.

At first glance, the 8th Amendment may seem innocuous or merely aspirational. However, over time, this provision has led to a near-absolute prohibition on abortion in Irish law and serious infringement of pregnant people’s rights. Under the current law, abortion is only lawfully available in Ireland when a woman will almost certainly die without it, and even then multiple doctors usually have to agree that this is the case.

“More than three decades of activism have come together in a large, vocal, visible and highly effective campaign for political and legal reform.”

Now, though, there are signs of change. More than three decades of activism have come together in a large, vocal, visible and highly effective campaign for political and legal reform; for the removal of the 8th Amendment and introduction of a law that will enable women to exercise agency in pregnancy and ensure that, for those who want to avail of it, abortion care is available at home in Ireland.

On Monday, the Irish Cabinet announced its intention to hold a referendum to repeal Article 40.3.3 in May 2018. The People will be asked to delete this Article and to insert a provision that expressly says that provision may be made by law for the termination of pregnancy. The Taoiseach said that the referendum will present the People with a choice to enable the Irish parliament to legislate for abortion care at home, or to continue to export abortion to other jurisdictions and to put the lives of women in Ireland at risk.

The Cabinet will publish indicative legislation for a GP-led abortion service ‘on request’ up to 12 weeks, and more limited access to abortion in later pregnancy.

Hamill Aoife - 205kTravelled - Signs - London Irish Arc 2

After the referendum

In the book we look beyond the referendum, to what might come next once the 8th Amendment no longer absolves the Oireachtas of the responsibility to make law to provide for the needs of women in Ireland. We include detailed proposals for how new legislation on abortion might be designed, including draft legislation that gives effect to the proposals that appear to have received Cabinet support this week in a way that respects the rights of pregnant people in Ireland.

“…the rights of pregnant people can be developed in ways that truly respect and protect bodily integrity, privacy, and the right to be free from inhuman and degrading treatment.”

In doing this, we argue that repeal of the 8th Amendment would create opportunities for the progressive interpretation of the Constitution, so that the rights of pregnant people—for so long narrowed down to a bare right to life said to be equal in stature to that of an unborn foetus—can be developed in ways that truly respect and protect bodily integrity, privacy, and the right to be free from inhuman and degrading treatment. This, we argue, would compel the Irish state to provide for lawful abortion, but would allow it to pursue the socially valuable objective of preserving foetal life provided in doing so it respects the constitutional rights of pregnant people.

This can be done by introducing law that makes abortion available without restriction as to reason up to at least the twelfth week. After that such a law might make lawful abortion available on broadly drawn health grounds so that pregnant people can truly determine the course of their own reproductive lives, and so that victims of sexual violence or those who have received unexpected foetal diagnoses will be able to be supported through a decision to an end a pregnancy, rather than forced through a punitive ‘qualification’ processes. This is what we are calling for now that the Referendum has been announced.

Like the Citizens’ Assembly and Joint Oireachtas Committee on the 8th Amendment, we draw distinctions between the availability of abortion after 12 weeks and after 24 weeks, with later abortion (after 12 weeks) being truly exceptional in law, just as it is in life. Illustrating the feasibility of such an approach, we include in the book draft legislation that gives effect to this approach. This makes our book essential reading for anyone involved in the campaign.

Our objective in writing this book was threefold. First, we wanted to make the constitutional arguments about the 8th Amendment clear and accessible and, in so doing, to show that from a legal perspective there is nothing unusually difficult about legislating for abortion and no reason why, uniquely among medical procedures, it should be regulated within the text of the Constitution. Second, we wanted to show how the Constitution itself could develop after repeal to reinvigorate the personal rights of pregnant people and to strike a balance between protecting these legal rights and pursuing the social objective of preserving foetal life through voluntary, consensual, and well-supported pregnancy. Finally, we wanted to show that, by drawing on experience in other countries and on international human rights law, and by committing to ensuring that pregnant people have sufficient certainty and support to make decisions about their own reproductive lives, a workable, reasonable, and rights-based law on access to abortion can be imagined and designed for Ireland.

Now, with the announcement of the Referendum on the 36th Amendment to the Constitution, we are a step closer to achieving some of these goals, but there is still much work to do. Given this week’s developments, Policy Press has brought forward the publication of the book to 1 February: please circulate information about it to anyone who is involved in the debates around the referendum.

 

Repealing the 8th: Reforming Irish abortion law‘ by Fiona de Londras and Mairead Enright  is publishing on 1 February 2018 and is available with 20% discount on the Policy Press website. Pre-order here for just £10.39.

It will be available Open Access under CC-BY licence.

Find out more about impact, influence and engagement at Policy Press here.

Policy Press newsletter subscribers receive a 35% discount – sign up here.

The views and opinions expressed on this blog site are solely those of the original blog post authors and other contributors. These views and opinions do not necessarily represent those of the Policy Press and/or any/all contributors to this site.


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