The industrial revolution produced an explosion in new forms of social organization. From the United Nations to trades unions, from the voluntary sector to welfare states, new systems and partnerships were designed to ease the transition from one socio-economic order to the next.
But today, across the globe, these organizations find themselves out of step with modern challenges and expectations. The Fourth Industrial Revolution requires a sibling social revolution. How can we make this happen?
First, we must stop our expensive attempts to manage the problems better. Then we must start, with communities and professionals, to design something new. This is what I have been doing across Britain, with people like Anne.
Anne is unwell, in pain and overweight. Keeping appointments with nine specialist doctors is her full-time job. But when I meet the doctors, they tell me something Anne already knows: the drugs don’t work. Anne represents the biggest challenge faced by health systems globally, which is how to shift from the last century’s fight against infectious disease to the present challenge of living with chronic illness.
One in four of us have a chronic condition such as diabetes, depression or the complications of old age. Our health services can’t cope. Seventy percent of UK hospital expenditure is dedicated to managing these complex conditions that cannot be cured. Anne needs radical help to change the way she lives.
The mismatch between the services on offer and the 21st century's challenges goes beyond health. From loneliness to ageing, education to modern work, our systems are out of kilter and beyond re-organization.
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Take employment. In the UK, job centres have been re-named and the benefits re-calibrated, but the essentials remain the same: they dole out money and advice. Two thirds of unemployed people who submit to the compulsory job application process in order to receive welfare, do not get employed. So they go round again and again.
At the start of a new industrial revolution powered by digital and other emergent technologies, we need new skills and different ways to find work. Today, most jobs are not advertised. To find work and to progress, you need social connections. The millions of Britons struggling in low-paid work know this, as do the millions of young people across the world looking for their first opening. They need something new.
In a South London job centre, I put up a door emblazoned with the cry: ‘get me out of here!'. I wanted to try a different approach, one that started with people’s own dreams. We brought together people both in and out of work, and focused not on the job alone, but on how to get up the ladder when in work. I asked anyone who wanted to join to pay £5 and come through the door.
With those who walked through, I used simple tools and public meetings to connect people and take practical steps towards long-term goals. Cheap digital platforms enabled us to work with many people at a low cost. We had an impact. Our approach fostered skills and enabled 87% of members to make progress in or towards work, while costing one fifth that of current services.
This is 21st-century welfare. It starts where you are, and instead of commanding change or trying to fix you, it offers support to grow capability. It includes as many people as possible, given that it is our relationships that help us find work, keep healthy and care for one another.
I design with people. I ask families who are angry and locked out to draw on new support with transformative results. I work with older people creating community services that bring joy and affordable, warm care. I honed this way of working in the barrios of Latin America and the compounds of Southern Africa. From London to Maputo, people’s lives change. Change for Anne started when she was encouraged to start her needlework again. The remedy might look unfamiliar, but the results impressed clinicians.
Radical as they may sound, these ideas are not new. They cost less money, but they are on the margins, working in spite of our post-war institutions. As Britain emerged from the ravages of war and the economic crisis of the 1930s, William Beveridge, the architect of the welfare state, declared it was "a time for revolutions, not for patching". He exported his revolution around the world, providing an organizational and intellectual blueprint for how we think about welfare.
But today we need a Fourth Social Revolution. These industrial systems do not work. They cannot harness the energy and the potential of this century, and we must think again. 'Radical Help' shows how.
'Radical Help: How we can remake the relationships between us and revolutionize the Welfare State' is published by LittleBrown.