Book review – Radical Help: How We Can Remake the Relationships Between Us and Revolutionise the Welfare State, by Hilary Cottam (2018)

Book Review

Radical Help: How We Can Remake the Relationships Between Us and Revolutionise the Welfare State. By Hilary Cottam. 2018. 308pp.

By Carolyn Hirst

I first read Radical Help by Hilary Cottam in October last year and I have been urging people to read it ever since. So I am delighted to have the opportunity to encourage more readers through this (fairly uncritical) book review. And while the book might not have direct relevance to Administrative Justice, it raises issues and potential approaches (with an emphasis on social rights and a focus on the small places and everyday), which I think will be of interest to some working in this area.

Essentially, what Hilary Cottam presents in her book is a new vision and a radically different approach. Early on she says that “Our welfare state is not fit for purpose …. it is at a loss when confronted with a range of modern challenges from loneliness to entrenched poverty, from a changing world of work to epidemics of obesity and depression…… It has now become a management state: an elaborate and expensive system of managing needs and their accompanying risks” (p. 12).

Part I of the book sets out three reasons why the welfare state cannot work for us in the 21st century. The first is that we are facing different social challenges which were not foreseen when the welfare state was designed. The second is that we have a crisis of care. And the third is that poverty and inequality have not been addressed adequately.

Cottam argues that our relationship with the welfare state has been profoundly altered. In the beginning it was a shared project to build a better Britain for everyone and the services on offer were a means to an end (they housed us, educated us and took care of our health) and not the end itself. Now we are customers of welfare services – there is an ‘obsession’ with service delivery and the culture is one of a business. She also says that the impact has been equally corrosive for those who work within welfare services – they are now ‘rated’ as we might rate a visit to a restaurant – and organisational cultures increasingly reflect those of the market – arms-length and transactional.

Cottam believes that we have reached the limits of our post war services and institutions – they were designed for a different era. Her view is that we cannot fix these systems, but we can recover the original intention and reinvent it for our times.

In demonstration of this, Part II of the book describes five core experiments (there is a chapter on each) where a solution was designed and tested. The experiment in Family Life works with families in Swindon, in Growing Up it is an intergenerational project, in Good Work the project looks as why the Jobcentre approach is not working, the Good Health project was designed to support those with long-term conditions live healthier and happier lives, and in Ageing Well the project enabled older people to connect with and support each other. These are very informative examples, and my only quibble with her here is that she does not seem to advocate connections with other organisations in the community who could contribute to providing support, such as faith groups and sports organisations.

At the heart of each of these experiments was the premise that we must make a radical shift that leaves behind the c20th approach about managing needs and sticking people back together again once things go wrong. Cottam advocates that we need to focus on supporting individuals, families and communities to grow their own capabilities: to learn, to work, to live healthily and to connect with one another.

Each of the experiments in the book used a design process which is participative from the outset and has two waves of thinking and making. The design process is about practice: about making, reflecting, taking apart and making again, and the creative process of building new solutions mirrors the process of capability growth in people’s lives. Each wave diverges (at first the thinking is wide and generative) and then converges as ideas are sifted and consensus is built. Moving through the two waves takes about nine months.

Part III of the book is about Making Change and refers back to some of the issues raised in Part 1. Here Cottam says that our current welfare systems have a logic that runs like this: assess me, refer me, manage me. The experiments proposed a different logic: Foster a core set of capabilities so that each and every one of us can thrive; Ensure, where necessary, that we are supported in the fact of adversity; Include as many people as possible; Measure change and the quality of our lives: our sense of freedom, purpose, of having something to give and our connections to one another. She describes this as being ‘radical help’.

The last chapter is about transitioning from a system that manages us to one that encourages us to flourish. Cottam considers that scaling up the approaches in the experiments would be the wrong approach, as this is a process of ‘industrial roll-out.’ I agree with this – and also with her view that scaling is a linear process and that growth is modular – and that we need to create the conditions for growth. This is about seeding models in new places so that they can take root, and connecting people in ways which remain true to the principles – while enabling local adaptation.

Cottam also believes that success depends on three factors: a shared vision, local leadership and a commitment to core values. And the book ends by saying that there are things we can do now. Firstly, we can identify those existing initiatives and experiments which are true to the principles described – that foster capabilities, support their workers, pay fairly and are committed to sustainability – and we can support and connect these.

Secondly, we can continue to grow both practice and practitioners. This includes continuing to experiment and finding new ways to support professionals. She says that we need more people who can combine critical thinking with the ability to make and create, and new career structures that recognise the importance and prestige of doing and supporting change.

Thirdly, we need to invest in the new. Cottam says that we need to prioritise funding for those models which are being run according to the core principles of radical help. She says that politicians must lead this change and the state has to take a role in funding new practice and setting the frameworks – including new measurement frameworks – for others to follow.

I found this book to be inspirational, particularly the view that the heart of this new way of working is human connection – and that change happens when people feel supported by strong relationships. But I do have a couple of minor concerns. One is that I am unsure about whether there is the impetus needed to introduce the radical changes she advocates happening (this was the Second World War in relation to the current Welfare State) and the other, in these times of financial constraint, is how and whether we can find the much needed money and political champions.

Carolyn Hirst is a professional mediator and independent researcher who can be followed on Twitter via @cahirstworks.