Social policy is apparently everywhere these days, embedded in everything from soap opera storylines to arts funding criteria. Yet, for all its pervasiveness in our culture, it is rarely discussed in its own terms. This is a problem because instead of policy makers trying to find ways to better meet people’s needs, they are more likely to be found promoting behavioural change or advocating intrusive interventions into people’s lives. The Social Policy Forum aims to challenge social policy by stealth, while taking a closer look at some key policy debates on everything from housing, social care and welfare, to the reforms of local government and public services.
Email: martin_earnshaw@hotmail.com for details.
Wednesday 24th February
Designing behaviour and healthcare
David Cameron has said “I’ll cut the deficit. Not the NHS,” but regardless of what happens at the next election, it seems that the health system will be run on a different basis from the universal system of the past. As Shadow Health Secretary Andrew Lansley says, his proposed Department for Public Health will have “a stronger remit for preventing disease, rather than just its cure. Whenever possible, we will ensure that national public health initiatives funded by public money are focussed wholly on behaviour change and paid for on the basis of the results they achieve.”
The shift towards a provision of healthcare organised around behaviour change will increasingly mean judging access and use of provided services according to whether the individual leads a healthy lifestyle. The motivation for this is not just cutting back public expenditure, even though “unhealthy lives” apparently drain spare resources. Policy makers want to redesign services more closely around peoples’ needs and investigate ways to prevent those same problems occurring in the first place. By focusing on the individual patient, the state can claim that it is acting in our best interest, and even that this approach is more egalitarian as they can understand and connect with vulnerable or disconnected communities in need of support.
Is this behaviour led approach more benevolent than the old universal model, will it result in better healthcare, or is it unacceptably authoritarian?
Readings:
The stated aims of increased data sharing are improving services to the public by joining them up in more logical ways than given by current organisational boundaries; by reducing the bureaucracy the public experience of repeat contact, and unnecessary and repeat form filling; and by giving better value for money by rationalising systems and processes. In addition, the public protection dimension (e.g. crime and disorder, child protection) is considered critical so that professionals across service boundaries can serve the public better.
The most controversial aspect of the discussion is around the sharing of personal data. It is argued, for instance, that explicit consent from the public should be gained before any information can be shared. While it is not clear the extent to which the principle of informed consent is shared either within government or more generally by the public; the notion of the need to share data is now deeply embedded in public service delivery.
Do the stated aims of data sharing fully explain what is driving this trend? Or do they reflect the changing relationship between public and state? Is there cause for concern or should we be fairly relaxed that there are enough safeguards in place to protect our personal data from abuse?
Introduced by Jo Herlihy. Read her introduction here
Readings:
Database State, Joseph Rowntree Reform Trust report http://www.jrrt.org.uk/uploads/Database%20State.pdf
Putting the Frontline First: Smarter Government http://www.hmg.gov.uk/frontlinefirst.aspx
Email: martin_earnshaw@hotmail.com for details.
