Change that leads to better lives

Austerity with Integrity

About eighteen months ago, NDTi (or to be more precise one of our Associates, Simon Whitehead), coined the phrase ‘austerity with integrity’ in a discussion about how we behave in the current economic climate.

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It is a phrase that has a certain resonance in these turbulent times, bringing together two important concepts – principles and reality. Keeping a hold on both is a challenge we all need to face up to. I’ve never been a great one for political posturing (or at least not since my student politics days). It makes you feel good at the time, but rarely results in achieving the things you set out to do. Fortunately, there is little political posturing taking place in the disability and ageing fields right now. Most people are recognising that the country is in an economic mess and that somehow, we need to find a way through it.

(Sorry, but I can’t resist a brief diversion into the roots of our economic mess. It’s clear to me that it was primarily caused by the international banking system – lending irrationally, encouraging debt amongst individuals and nations for their own profit and then taking public money to bail themselves out before carrying on behaving in broadly the same ways. I don’t buy the argument that our Government (probably unlike the Greeks) spent unwisely and excessively. Borrowing to finance investment and growth is how business and society works. That’s what the UK government did, so blaming them for it going wrong when the international banking system collapsed in an unprecedented way seems a tad harsh).

Back to the subject. What is worrying me is that whilst most people and organisations are rejecting political posturing in favour of reality – in the process they appear to be forgetting values and principles. In other words, austerity without integrity. Managers have to operate with budget restrictions, but two things need to go alongside that. Firstly, before instigating cuts in services, asking ourselves what the consequences will be for the people at the receiving end and whether there are better ways of achieving those savings. Secondly, by being overt and explicit about the consequences of spending less money - so that the public and policy makers are properly informed about its impact when considering public investment priorities.

Let’s take the first of those. Two alternatives seem to be happening across services. Firstly, salami slicing - taking a stated percentage off all services without any real consideration of impact. This feels a cop-out – passing responsibility for decisions and impact onto those closer to the front line, in particular service providers. The other approach is a decision to cut defined services, with a statement that this is based on priority reviews, but without the data and evidence to support that decision.

A couple of examples we have found recently illustrate this:

  • NDTi will shortly start publishing the outcomes from its research into employment support for people with disabilities. This will describe reducing expenditure this year. It will also show that most commissioners have neither financial nor outcome data to steer a decision on which services to keep and which to retain or develop. So how are those decisions being taken? Where is the integrity in that set of austerity-driven actions?
  • Perhaps more stark is the local authority that has imposed a unilateral cut of up to 50% in funding to specific providers – without prior review of individual services. They have asked for no outcomes data to support this. They are also then describing the resultant allocations to the provider as a personal budget. Thus the concept of personalisation is immediately associated in people and families’ minds with major service cuts. Thus, people’s services get worse and a potentially positive concept of empowerment becomes debased.

There are other ways of doing things that demonstrate austerity and integrity. Again - examples from our recent work:

  • A London authority had to cut spending on mental health day services but also knew that the current services were outdated and producing poor outcomes. They are now re-shaping services to focus on inclusion – accessing community resources based on people’s life expectations. Some people will lose services, but others should have better lives and, over time, probably place fewer demands on services.
  • A provider who took assistive technology seriously, which both helped address budgetary problems and gave people some more control over their lives without having staff around them when they weren’t really wanted.

I’m not arguing for big budget cuts, but substantial budgetary pressures can be a catalyst to positive change if we are prepared to think differently and use evidence to inform our actions. If we stick with traditional thinking and then fail to collect and use the evidence of budget and service reductions on people’s lives we commit a double sin. This is my second point from earlier on. Too many important players – commissioners and providers and crucially their representative bodies – seem to be quiet about impact.

The political pressure to accept the reality of the economics may mean we all have to take the consequences and plan accordingly, but it doesn’t mean we have to stay quiet about the impact. It is possible to be a good responsible manager, grit your teeth and take tough budgetary decisions, whilst also being a part of speaking up about the consequences so that society (and the politicians) know what is being done in their name. Taking those decisions without considering and evidencing the likely impact on people, and then not tracking what is happening to people and their lives as a consequence, strikes me as being a clear case of austerity without integrity – and that is not the approach that motivated most people to come into this field of work.

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