Open access. Some rights reserved. · 2021. 1. 23. · councils, David Halpern, Adam Heathfield, Ed Mayo and Hilary Cottam who all at different times added ideas to this pamphlet

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About Demos

Demos is a greenhouse for new ideas which canimprove the quality of our lives. As anindependent think tank, we aim to create an openresource of knowledge and learning that operatesbeyond traditional party politics.

We connect researchers, thinkers andpractitioners to an international network ofpeople changing politics. Our ideas regularlyinfluence government policy, but we also workwith companies, NGOs, colleges and professionalbodies.

Demos knowledge is organised around fivethemes, which combine to create newperspectives.The themes are democracy, learning,enterprise, quality of life and global change.

But we also understand that thinking by itself isnot enough. Demos has helped to initiate anumber of practical projects which are deliveringreal social benefit through the redesign of publicservices.

We bring together people from a wide range ofbackgrounds to cross-fertilise ideas andexperience. By working with Demos, our partnersdevelop a sharper insight into the way ideasshape society. For Demos, the process is asimportant as the final product.

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PersonalisationthroughparticipationA new script for publicservices

Charles Leadbeater

Open access. Some rights reserved.

As the publisher of this work, Demos has an open access policy which enablesanyone to access our content electronically without charge.

We want to encourage the circulation of our work as widely as possible withoutaffecting the ownership of the copyright, which remains with the copyrightholder.

Users are welcome to download, save, perform or distribute this workelectronically or in any other format, including in foreign language translationwithout written permission subject to the conditions set out in the Demos openaccess licence which you can read at the back of this publication.

Please read and consider the full licence.The following are some of theconditions imposed by the licence:

● Demos and the author(s) are credited;

● The Demos website address (www.demos.co.uk) is published together witha copy of this policy statement in a prominent position;

● The text is not altered and is used in full (the use of extracts under existingfair usage rights is not affected by this condition);

● The work is not resold;

● A copy of the work or link to its use online is sent to the address below forour archive.

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Contents

Acknowledgements 9

Foreword 11

Introduction 15

1. How to help Anne 27

2. Services as scripts 34

3. Better basics 38

4. Consumerised services 44

5. Citizen-led services 53

6. Personalisation through participation 57

7. The politics of personalised services 80

Notes 91

Acknowledgements

Demos 9

Thanks to Tom Bentley, David Hargreaves, SophiaParker, Mathew Horne, Paul Miller, and thepublic services team at Demos, David Miliband,Peter Housden, Jim Maxmin, David Henshaw,staff at Kingston, Blackburn and Liverpoolcouncils, David Halpern, Adam Heathfield, EdMayo and Hilary Cottam who all at differenttimes added ideas to this pamphlet throughdiscussions and seminars.

Charles LeadbeaterMarch 2004

Foreword

Demos 11

This is an important pamphlet about anabsolutely vital subject. High quality publicservices can provide liberation for millions ofpeople. Yet when public services fail to meetpopular aspirations, their whole basis comesunder threat. This pamphlet engages with the keydebate facing politicians, policy-makers, staff andthe public – whether we can build a model ofpublic service delivery that overcomes thelimitations of both paternalism and con-sumerism. Since the answer in the pamphlet tothis question is ‘yes’, it is especially important thatpeople engage with its contentions.

As a minister in a public service ‘delivery’department, three dilemmas recur as I try tomake my contribution to the renewal of publicservice in Britain. First, how to combine

excellence and equity, and more particularly howto use excellence as a battering ram againstinequality. The Right say this is not possible. TheLeft is ambivalent, fearing that a drive to promoteexcellence as well as tackle low performancemight create inequality. Yet it is precisely theexcellence that can be developed in the publicsector that is both an example of what is possible,and a potential driver of system-wide improve-ment.

Second, there is the need to ensure universalservices are shaped by the personal touch. This isCharles Leadbeater’s starting point. I like hisanswer: engage individuals, alone or in groups, inassessment of need as well as development ofservice, and you will bring out the best in publicservice staff, as well as bringing a smile to thosewho use the service. This requires systems inwhich innovation and diversity are the order ofthe day; because people are different, serviceshave to be different.

The third dilemma is about how we get theflexibility that public service staff need if they are

Personalisation through participation

12 Demos

to deliver personalised and diverse services,without sacrificing the accountability that isessential if we are to raise quality. The debatewithin the education system about ‘intelligentaccountability’ points one way forward – moreinformation available to the public, not less,presented in an accessible form. This seems to bewhat is happening in the health and criminaljustice systems too. It should be of benefit not justto the public as ‘choosers’, but also to publicservants as they seek to manage the improvementin performance by learning the lessons of thebest.

Each of these three dilemmas echoes throughthis pamphlet. It is a contribution to the debatenot the final word. The recipe of ‘basics pluspersonalisation’ may not trip off the tongue, but itspeaks to real need and real aspiration. As such,the pamphlet is a significant contribution to thedebate about public service reform. It is onewhich makes me optimistic that as a country weare finding the right ways to use risinginvestment, and deliver the expansion and

Foreword

Demos 13

improvement of capacity that the public sodesperately want to see.

David Miliband MPMinister of State for School Standards


14 Demos

Introduction

Demos 15

On 24 March 2004 the Department of Healthmade an important announcement heraldingimpressive reductions in heart disease: between1997 and 2002 there had been a 23 per cent fall indeaths from diseases of the heart and circulatorysystem.

Much of this reduction was due to reforms toNHS cardiac services, particularly improvedtreatment of people who had suffered a heartattack, involving better medicines, technologiesand working practices. About 1.8 million peoplewere taking statins, cholesterol-reducing drugs,thus reducing the number of premature deathsper year by 7,000, the department said. But thereport also acknowledged that much of thedecline in heart disease deaths was due to lifestylechanges that swept the country 20–30 years

earlier, when middle class men in particular gaveup smoking in their millions.

Contained in this single story are two verydifferent accounts of how the public good iscreated.

The first account is that the public good –fewer people dying young from heart attacks –comes from the state providing services to societyever more efficiently and effectively. The publicgood goes up the more effective the state becomesin solving society’s problems for it.

The second account is that the public good –fewer people dying young from heart attacks –comes from millions of people making looselyconnected decisions in society to change the waythey live, which collectively produces a significantimprovement in the public good. In this modelthe state does not act upon society; it does notprovide a service. Instead the state creates aplatform or an environment in which people takedecisions about their lives in a different way. Thisis bottom-up, mass social innovation, enabled bythe state. From this point of view the fact that 1.8


16 Demos

million people are turning to the NHS to getstatins is not a sign of success but a sign of failure.It would be far better if these people had lifestylescompatible with low cholesterol, rather than takedrugs to deal with the problem after the event.

These two approaches to innovation – moreeffective top-down and more pervasive andpowerful bottom-up – are not necessarily at odds.They could be complementary. Indeed the state’scapacity to deliver better and better services, withlimited resources, will depend on it encouragingpeople to become more adept at self-assessingand self-managing their health, education,welfare, safety and taxes.

Yet these two approaches entail quite differentaccounts of the roles of users, professionals andpublic service providers. In the first approach theusers are patients in need of timely and effectiveservices from the NHS that are personalised totheir needs. In the second approach the users areco-producers of the good in question. They areactive participants in the process – deciding tomanage their lives in a different way – rather than

Introduction

Demos 17

dependent users. In the first approach the pro-fessionals – medical practitioners – must deploytheir knowledge and skills in a timely andeffective way to solve a problem for the user. Themore that is done in a personalised, considerateand responsive manner the better. In the secondapproach the key is to build up the knowledgeand confidence of the users to take actionthemselves, to self-manage their health withoutturning to the professionals. The professionalsdeploy their knowledge to help the users devisetheir own solutions – smoking cessation program-mes, exercise regimes – which suit their needs.

The differences between these two approachesto generating the public good go to the heart ofthe debate about what ‘personalised’ publicservices should look like.

Personalisation is a very potent but highlycontested and ambiguous idea that could be asinfluential as privatisation was in the 1980s and1990s in reshaping public provision. Privatisationstarted as a Conservative policy in 1984 at theheight of neoliberalism but has since been widely


18 Demos

adopted around the world by governments ofdifferent political persuasions. Personalisationcould have a similar impact and reach because itcould provide a new organising logic for publicprovision, linking initiatives of the first type,more personalised public services, to initiatives ofthe second type, creating the public good fromwithin society.

Privatisation was a simple idea: putting publicassets into private ownership would create morepowerful incentives for managers to delivergreater efficiency and innovation. Personalisationis just as simple: by putting users at the heart ofservices, enabling them to become participants inthe design and delivery, services will be moreeffective by mobilising millions of people as co-producers of the public goods they value.

Personalisation has the potential to reorganisethe way we create public goods and deliver publicservices. But to unlock that potential the ideaneeds to be taken much further than currentgovernment thinking seems to allow. At themoment personalisation seems to mean

Introduction

Demos 19

providing better access and some limited say forusers over how existing services are provided inlargely traditional ways. This ‘shallow’personalisation offers modest modification ofmass-produced, standardised services to partiallyadapt them to user needs. ‘Deep’ personalisationwould give users a far greater role – and also fargreater responsibilities – for designing solutionsfrom the ground up. Personalisation could justmean more 24/7 call centres, booked appoint-ments and timely access to standardised services.At the other extreme it could mean promotinggreater capacity for self-management and self-organisation. Personalisation could be a sustain-ing innovation designed to make existing systemsmore personalised or it could be a disruptive inno-vation designed to put the users in the driving seatas designers and paymasters of services. It could bea programme to apply a lick of new paint to fadingpublic services or it could be the harbinger ofentirely new organisational logic.

Personalised public services could have at leastfive different meanings.


20 Demos

First, personalisation could mean providingpeople with a more customer-friendly interfacewith existing services: 24/7 call centres, bookedappointments, guaranteed fast response times,better basic customer service. Public serviceprofessionals should be available to users whenthe users want the service, not the other wayaround. Given the way that much of the publicsector still works, enacting such basic reforms tomake it easier for people to get access to theservices they want, when they want them, wouldmake a huge difference. This would be asustaining innovation: it would sustain supportfor existing services by making them morepersonalised.

Second, personalisation could also mean givingusers more say in navigating their way throughservices once they have got access to them. Thusin the health service, ministers talk about ‘patientpathways’ through the system, and in secondaryeducation, children will be given more choiceover the pace and style at which they learn. Publicservice professionals should take more account of

Introduction

Demos 21

users in the way that they deliver the service tothem, keeping them informed and giving themample opportunities to choose between differentcourses of action.

Third, personalisation could mean giving usersmore direct say over how money is spent. Userswould be given more power to make their owndecisions about how to spend money allocated totheir education or operation. Public serviceprofessionals would not make all the decisionsabout how resources should be allocated butwould have to respond to user demand. A goodexample is the way some local authorities allowdisabled people to commission their own carepackages, working with advice from professionals.In this case, the users are far more knowledgeableabout what they need and how to get it thanmany of the professionals. The role of the state isto enable such a managed market in provision tocome into being: helping to inform users aboutavailable choices and ensuring good qualitysupply.

Fourth, personalisation could mean users are


22 Demos

not just consumers but co-designers and co-producers of a service: they actively participate inits design and provision. Good examples of thisinclude community safety initiatives, recuperativecare programmes for the elderly and manywelfare-to-work schemes in which the ‘users’actually do a lot of the work themselves becausethey want to find solutions that do not leave themdependent upon the state. Public serviceprofessionals help build up the knowledge andcapacity of the users to create their own solutions.

Fifth, personalisation could mean self-organisation: the public good emerging fromwithin society, in part, through the way thatpublic policy shapes millions of individualdecisions about how we exercise, eat, smoke,drink, save for our pensions, read to our children,pay our taxes and so on. Many of our biggestsocial challenges – reducing obesity and smoking,caring for people with chronic health conditions,promoting learning, creating safer communities –will only be met if we promote a mass socialinnovation within society: self-organising

Introduction

Demos 23

solutions. Public service professionals would helpto create platforms and environments, peer-to-peer support networks, which allow people todevise these solutions collaboratively.

As we move from the first to the fifth of theseoptions the implications become more radicaland disruptive: dependent users becomeconsumers and commissioners, and eventuallyco-producers and co-designers. Their participa-tion, commitment, knowledge and responsibilityincreases. As the role of the user fills out, so therole of the professional must change in tandem.In the first two options professionals are stillproviding solutions for dependent users, albeit ina more personalised fashion. In the fifth, theprofessionals are designing environments, net-works and platforms through which people cantogether devise their own solutions.

How far does the government want to go withpersonalisation? Is it just an attempt to bringbetter customer service into the public sector inresponse to complaints about over-centralisationand bureaucracy? Is it an attempt to woo middle


24 Demos

class consumers to keep them loyal to publicservices by giving them more choice? Or is it anidea that could sustain waves of reform, leadingfrom incremental innovations to existing publicservices but eventually leading to more radicalsolutions that combine better public services withmore capacity for self-organising solutions insociety?

The argument of this pamphlet is that onceyou start personalising public services people willget an appetite for it. They will want more. Thegenie will be out of the bottle. Rather thancontain personalisation the aim should be to takeit further and deeper. The aim should not be tosustain existing, often outmoded, forms ofprovision. The aim should be to disrupt thesemodels and find new, more adaptive solutions.Some will argue that promotion of collaborativeand self-organising solutions is a pipe dream, thestuff of open source communities on the internet,Linux and e-Bay, perhaps, or the mutuals andcooperatives of the nineteenth century, but not amodern solution. But go back to the example we

Introduction

Demos 25

started with: heart disease. Further reductions inpremature deaths from heart disease will comefrom more personalised public services. But farmore gains will come from persuading people totake more exercise, eat healthier diets, stopsmoking and not drink too much alcohol. Futurebig, cost-effective reductions in heart disease willturn on self-organising solutions: the fifth andmost radical form of personalisation set outabove. The challenge of personalisation is notjust: ‘how do we create more personalisedversions of existing public services?’ The realchallenge is: ‘how do more personalised publicservices help people to devise their own, bottom-up solutions, which create the public good?’ Thatis the question this pamphlet seeks to explore.


26 Demos

1. How to helpAnne

Demos 27

The fact that Anne Rhodes is still with us is atestimony to public services. Anne was born withcerebral palsy and spent most of her early yearsshuttling to and from hospitals for operationsthat saved her life. Thereafter she went to aspecialist school for children with learningdisabilities. When most people her age wereleaving school for jobs or college Anne wasdirected to an Employment Resource Centre onthe edge of her home town, Blackburn. TheCentre was meant to provide a secluded, safeenvironment, in which disabled people could douseful work. On her first day staff asked Annewhat she would like to do: make curtains ortapestry. Anne shrugged, not sure that eithermuch interested her, so she plumped for tapestry.She followed that routine every day, for 17 years.

No one ever suggested she do somethingdifferent. That was all that was on offer.1

Anne Rhodes’ position sums up the asymmetryat the heart of public services: professionals andproviders have the budgets, power and infor-mation; users do not. How would the variousproposals on offer for improving public serviceshelp Anne Rhodes?

One argument is that public services just needmore money and staff. Users just want a betterversion of the existing service, brought ‘up todate’. That would mean giving Anne Rhodesbetter needles, thread and thimbles, a better wayto do tapestry: something she never wanted to doand which has yielded few benefits for her orwider society.

A second argument is that Anne should be setfree as a consumer, with the funds to buy servicesto suit her needs. Producers would have torespond to her demands. Yet Anne Rhodes finds itdifficult to walk around, let alone shop around.She is bright but short on confidence and finds ithard to communicate. Liberating her as a


28 Demos

consumer would take far more than giving her awad of money and the freedom to spend it.

A third argument is that Anne should be seenas a citizen. The key feature of public services isthat they are collectively funded, with prioritiesset by democratic decision-making. Anne’sservice might be changed if she had a voice in itsgovernance through a seat on the centre’smanagement committee. But Anne is not used tobeing on committees and she does not want avoice in the running of the whole centre; shewants to be able to influence her service, directlyand immediately. The offer of citizenship is toovague and distant to offer her any real prospect ofchanging the kind of service she receives.

None of these proposals for reorganisingpublic services – reinvestment in existing services,consumer choice, citizenship and voice – wouldmake much of a difference to Anne. What didBlackburn Council do when they took over thecentre from Lancashire County Council in 1998?

Blackburn offered Anne an opportunity topersonalise the service she received by giving her

How to help Anne

Demos 29

the opportunity to participate in its design anddelivery. We need to understand what isdistinctive about how the council did this becausethis simple model could be a part of every aspectof public service provision. Personalisationthrough participation, the approach staff inBlackburn came up with instinctively, offers amore promising avenue for public service reformthan any other currently available. Here is how itworked in Anne’s case.

First, staff running the centre started anintensive, intimate and lengthy conversation withtheir clients to find out what they wanted to do. Itwas the first time in 17 years Anne had been askedwhat she wanted. Staff said their goal was forpeople using the centre to have the opportunity tobecome more independent, to gain the confidenceto stand on their own two feet. They drew up arange of training options Anne might consider.That limited opportunity to exercise choice andambition then unlocked Anne’s voice. She told thestaff she had always wanted to get a job but hadnever realised she might be able to do so.


30 Demos

Every Wednesday for six months, Anne went toa pre-vocational training course run byManchester Open College, designed to helppeople get ready for taking a job. When shefinished the course, staff from Anne’s centreorganised for her to work an afternoon a week ina nearby council nursery. After six months Anneand the staff at the nursery want her to workmore often. Anne wants to go on more courses.

‘I feel normal for the first time in my life,’ Anneexplained. ‘I am part of society not on the edge.’

Anne’s life was transformed only because stafftook the time to help her articulate the intricacyof her needs, gave her enough choice to voice heraspirations, and organised relationships withtraining providers and other partners to create asolution for Anne that the centre could not havedelivered. Crucially, Anne was an active, informedand increasingly articulate participant in thisprocess: the solution was personalised throughparticipation. As a result Anne felt more commit-ted to the service than she had been when it wasdelivered to her as a passive, dependent consumer.

How to help Anne

Demos 31

Public service reform should be user-centred.It should be organised to deliver better solutionsfor the people who use the services. But it mustalso, in the process, deliver better outcomes forsociety as a whole: effective collective provision tomeet the need for education, health, transport,community safety, care for vulnerable people. Thechallenge is to build these two sources of value –for the individual users and the wider society –together. The combination creates public value.Treating users as atomised consumers ignores thewider social influences on the choices they makeand the wider consequences of their choices, forexample, over which school to choose for theirchildren. Treating people as citizens, who canreshape services through formal political debate,is worthy but abstract. Only policy wonks thinkpeople will be excited by attending moremeetings. Users want direct attention to theirneeds.

That is why we need a new framework to showhow personal needs can be taken into accountwithin universal, equitable public services, how


32 Demos

effective collective solutions can be built up frommillions of personal decisions. The starting pointis to rethink what services are and how theygenerate value.

In the process we also need to develop a newstory about how change occurs in institutions andpublic service organisations – how they canreshape themselves through repeated interactionwith the people they serve and continuous effortto find better ways of serving them. This storyneeds to make sense for service users andpractitioners, but it also needs to be incorporatedinto the way politicians and civil servantsunderstand and undertake large-scale reform. Itneeds to be a story of what role the state plays increating public goods in a society in which peoplewant more choice, more voice and more scope forself-organisation.

How to help Anne

Demos 33

2. Services asscripts

34 Demos

Our models of production and consumption arestill dominated by industrially produced goods –cars, stereos, washing machines – the physical andtechnical characteristics of which can be easilydefined and compared. Shopping around for awashing machine in the basement of John Lewisinvolves comparing fairly standardised goods.Our images of what it means to be a consumer arestill dominated by this shopping mall idea ofchoosing between different physical goods.

This model is inappropriate for many services.True, more services are now standardised: witnesstelephone banking or fast food restaurants. Butservices that generate personal satisfaction orsolve personal problems – whether public orprivate – are far more difficult to define in quan-titative terms. It is difficult to shop around for

something that cannot be defined easily and to beeffective has to be designed with you in mind.

Services should be seen as scripts. All servicesare delivered according to a script, which directsthe parts played by the actors involved. The scriptfor eating a meal in a restaurant is: reserve table,arrive at restaurant and be shown to table,examine menu, place order with waiter, fooddelivered to table, eat, ask for bill, pay, leave.Service innovation comes from rewriting scriptslike this so the action unfolds in a different way. Afast food restaurant runs on a different script:read menu, place order for food, pay, take food totable yourself, eat, clear away your debris, leave. Ina full-service restaurant you eat and then pay, anddo very little else. In a fast food restaurant you payand then eat, and contribute some of your labourby taking the food to the table and clearing awayyour mess.2

Most service innovation comes from producersand users simultaneously adopting a new script,playing out new and complementary roles in thestory. It is very difficult for service producers to

Services as scripts

Demos 35

innovate unless the users also adopt the new rolesin the script. Increasingly innovation comes fromconsumers deciding to write new roles in theirscript for themselves and insisting that theproducers respond. That is the story of the rise ofSMS messaging. Mobile phone companies had ascript for how SMS messaging would be used: inemergencies. But teenage users of mobile phonesinvented a new script and with it a new serviceand new uses for mobile phones. The producershave had to respond to the script that wascollectively written by the users. Serviceinnovation is invariably a joint productioncombining producers and consumers.

Often radical innovation involves bringingtogether ideas from quite different scripts: thetelephone service script (used in banking) andhealth care knowledge, when brought together,created a new script for accessing health advice inthe form of NHS Direct. The old script was:phone GP, make appointment, visit surgery. Nowthere is a new script, which starts with a phonecall to NHS Direct asking for help.


36 Demos

Many of the scripts followed by public services– such as schooling – have not changed fordecades: enter classroom, sit at desk, listen toteacher, read from blackboard, write in exercisebook, hand in work, run to playground. Thescripts for user engagement with the police,health services and libraries are largely written byprofessionals, producers and regulators, not byusers. The users are expected to fit into the rolesgiven to them by the script handed down from onhigh.

How should we rewrite the scripts for publicservices?

Services as scripts

Demos 37

3. Better basics

38 Demos

One answer is that service scripts need rewritingto make them simpler, more efficient andresponsive. Most people want reliable, timelybasic services: trains that run on time, binscollected, housing repairs done swiftly, planningdecisions taken quickly. It is not rocket science.Nor is it simply about more investment. Thescripts by which services are delivered needrewriting. One problem with public services isthat the number of people and departmentsinvolved makes services bureaucratic, un-responsive and slow moving.

A good example of how service scripts can bemade simpler and more responsive is LiverpoolDirect, the joint venture between the city counciland BT to create a new way for users to accessservices. The venture, created in 2000, is due to

run over 11 years. BT put in an initial investmentof more than £60 million to create the technologyplatform for a call centre, web access and tointegrate IT systems. The Council pays the jointventure about £30 million a year to provide itwith services. As a result users can call theLiverpool Direct call centre 24 hours a day, sevendays a week, all year. The centre is getting morethan 50,000 calls a month. It has, quite literally,given users a voice in their services.

Take just two examples. The children’s socialservices team used to miss more than 50 per centof the calls made to it, mainly because socialworkers were out making visits and the answermachine in the office got overloaded. If you calledfor help, it was a lottery as to whether your callwould be logged let alone dealt with. Now thecouncil’s dedicated Careline service means thatless than five per cent of calls are missed. Socialservices workers sit alongside customer careoperatives in the call centre so that decisions canbe made while the caller is on the line. It used totake two days to allocate a social worker to a case.

Better basics

Demos 39

Now it takes an hour. Or take the more mundaneexample of bins. The council’s refuse collectionservice used to miss thousands of bins, in acollection round of more than 200,000 a week.Now the proportion of missed bins is less than 0.1per cent. Part of the explanation is that users cannow get through to the council to complain aboutan uncollected bin. In the past most of their callswere not taken.

Liverpool Direct is a tangible example of howusers have been given more say in their services.But that is just the starting point. To deliver onLiverpool Direct’s promises, services have beenre-engineered to make them simpler, swifter andmore responsive. Eleven different people had tobe involved in making a decision before a pestcontrol officer would visit a property to sort out arat infestation. Now the pest control officer can beallocated, with an appointment made over thephone, from the call centre.

The scope for basic improvements to publicservices – giving users a more direct and effectivevoice and streamlining services to make them


40 Demos

more responsive – is vast. Yet even these basicimprovements involve more than just doing thesame things a bit faster, with better equipment.Liverpool Direct shows that better basics comefrom redesigning services from scratch,rethinking the roles of professionals and otherstaff, even creating a new organisation to deliverservices.

Improving the basics, while necessary andpossible, may reduce dissatisfaction with poorservices without creating satisfaction. Research byMori on attitudes towards services shows thatusers are dissatisfied with services if they areinaccessible, unreliable, unfriendly or lacking incompetence.3 To eliminate dissatisfaction youhave to do the basics well by providing reliable,timely, competent services. However, once thosedissatisfaction factors are eliminated, furtherfocus on them may not create growingsatisfaction. Take bins as an example. People wanttheir bins collected on the same day every week,preferably around the same time. When that doesnot happen they grumble. But providing them

Better basics

Demos 41

with a 15-minute guaranteed time slot when theirbins will be collected may not further increasesatisfaction.

Some public services are starting from a lowbase: the task is to eliminate blatant sources ofdissatisfaction by doing the basics better. If theLiverpool approach is right this involves givingusers a far more direct voice in services andrewriting the delivery script around their needs.Ventures such as Liverpool Direct provide a basiclevel of personalisation: appointments, guaran-teed response times. But to generate more valueand more satisfaction, public services will needother approaches.

That means government has to play a morecreative role. But if central government intrudestoo far into people’s lives or imposes solutions itwill run into opposition. In a liberal, open society,the government’s chief role is to encourage theemergence of collective solutions from within asociety that wants greater scope for self-organisation and bottom-up initiative. It has tofind a new marriage between the top-down and


42 Demos

bottom-up organisation of public goods such aseducation and health. Where are we likely to findsuch a marriage? Some believe the answer will befound by encouraging public service users tobecome consumers.

Better basics

Demos 43

4. Consumerisedservices

44 Demos

This morning I bought a watch. I did not have totell anyone in advance. I did not sign any forms,nor did I have to get a watch-buying licence.Around the world about 40 million other peopleprobably bought watches today, each of whichrequired components to be made, faces printed,packaging shipped. The producer and retailer ofthe watch did not know I was going to buy it.They did not have to know anything about me.There was no grand plan to organise theproduction. I did not have to put my name downon a watch-waiting list. The market that broughtme together with my watch also coordinatedmillions of other decisions that organised theproduction of millions of watches. The fact thatwe can coordinate this complex web of individualdecisions without anyone having a plan or being

in charge is why it is difficult to be againstmarket-based consumerism for products such aswatches.

Consumer choice is a good thing in marketsthat trade goods and services where propertyrights are relatively clear, products are relativelyeasy to compare, consumers can gather infor-mation easily and there are many buyers andsellers of services. For products such as cars,stereos, computers, bank accounts, and airlinetickets, markets that allow consumers choice arethe best way we have found to organise economiclife. Consumer choice sends signals about whatpeople want that producers should organisethemselves around. In theory at least, this meansthat resources can be reallocated to reflectconsumer demand rather than reflecting whatproducers decide should be made. Consumerswho are well informed, able to form clearpreferences and easily exercise those choices in themarket are the arbiters of value.

Providing users with greater choice wouldshake up the public sector. As Andrew Turnbull,

Consumerised services

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the Cabinet Secretary, said in a recent speech:

People have written about disruptivetechnologies. I would describe choice asdisruptive governance. It really forces you tochange your view of the world. It is at thispoint that power really shifts. It is like thatinversion of magnetic north to magneticsouth that scientists talk of, whereaccountability for the first time really startsto flow downwards.4

Why shouldn’t elderly patients have a choiceabout where and when they get a hip operationdone, or parents more choice, within the publicsector, about the curriculum and ethos of theschool their children go to? Or take social carepackages for elderly people provided by socialservices: why shouldn’t the user make the choiceabout what mix of home-based services theywant, given the budget available? Why is thepublic sector so frightened of the choices that itsusers might make?


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In some services it makes sense to putconsumers directly in charge of commissioningthe service they want, especially where consumershave far greater knowledge than professionalsabout what they need and what might beavailable. A prime example is the expansion indirect payments to disabled people to allow themto commission their own home care packagessuited to their needs. In Kingston, a council thatpioneered this approach, Roy Taylor, the Directorof Community Services, explained how it works:

Disabled people tend to be really wellinformed about their conditions, what theyneed and where to get it. We’ve established abody with the voluntary sector to helpadvise them and to help organise themarket. But by and large disabled peopleare in a better position to know what theyneed than we are.

People in Kingston with disabilities are entitled toindependent living direct payments to then


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employ their own personal assistants. They do soin conjunction with the Kingston Centre forIndependent Living. Independent living centresacross the country have formed a self-helpnetwork which has borrowed ideas from similarnetworks in Canada which have as their goal:‘individual and community-based change whichpromotes self-determination and full partici-pation in society for people with disabilities.’ TheCanadian centres are largely staffed and governedby people with disabilities.

Making a reality of choice in other serviceswould require far-reaching changes, not least tofinancial flows. If a patient were able to choosefrom among several hospitals for an operation,that choice would be frustrated if the money didnot flow to the hospital he or she chose. To makean informed choice the patient would need muchbetter information, including the performance ofindividual surgeons and wards. Capacity wouldneed to shift in response to demand: organis-ations that became more successful and popularwould need to be able to increase their available


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capacity to meet demand, otherwise queueswould just lengthen.

Consumer choice would be a challenge to thepower of professionals and providers to allocateresources to services. But the extent to whichpublic services can be driven by consumer choicealso has limits.

� Consumerism assumes competitionthat allows consumers to choosebetween competing options. But insome public services – policing forexample – it does not make sense tohave competing providers, usingcompeting infrastructures. Compe-tition would lead to waste andinefficiency.

� Consumerism works where goods andservices can be packaged and priced.Yet the goods and services the publicsector provides are not always neatlypackaged in the way that stereos, carsand computers can be. Many public


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services are fuzzy, difficult to defineand pin down, for example the valueof community safety. The qualities ofthese public goods cannot be assessedand encapsulated in the way that thefeatures of a computer can bedescribed in technical language.

� Consumerism is based, at least intheory, on individual preferences. Butin public services it is often difficult toseparate one individual’s preferencesfrom another’s. Parents choose schoolsin part based on what other parents do.Simplistic models of consumer choicefail to take into account these socialand environmental factors.

� Consumerism works when consumershave good information about serviceperformance. But in the public sectormost information, and the ability tointerpret it, is in the hands ofprofessionals and staff. Users rarelyhave all the information they need –


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about possible costs and benefits ofdifferent forms of health treatment forexample – to make a fully informeddecision.

� As choice expands, the costs ofsearching across competing offersrises. As diversity expands it becomesmore difficult to compare differentservices. Choice imposes costs onconsumers as well as benefits.

� Market consumerism applied topublic services could threaten theprinciples of equity on which publicservices are based. Public servicegoods such as health and educationare essential to the quality of people’slives and their ability to play a full rolein society. These foundational goodsshould not be distributed by ability topay but according to need.

Further extension of choice of the kind somedisabled people now enjoy should be a vital


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component in public service reform. But giventhe difficulties involved, choice cannot provide asole organising principle for a reform strategy.Users of public services want to be treated well, ascustomers, but that does not necessarily meanthey want to become consumers, shoppingaround for the best deal or even threatening to doso. We need to find a way to make public servicesresponsive without turning the public sector intoa shopping mall. We need a way for users to betreated with respect and consideration when theycannot exercise the sanction of taking theirbusiness to another supplier.


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5. Citizen-ledservices

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Many on the centre left are attracted to the ideathat service providers should respond to the viewsof citizens. There are good reasons why publicservices should be organised around the prioritiesof the citizen:

� Citizens fund public services throughtaxation and their participation in thedemocratic process can have an influ-ence over how that money is spent.

� Citizenship speaks to the ideals ofequity and collective provisionembedded in public services. Peoplegenerally want good public servicesfor everyone, not just for themselves.

� Using a public service is not just aconsumer experience. Each

engagement with a public serviceshould deepen a sense of civicattachment and underpin a sense ofcitizenship: why it matters to be partof a democratic society.

The centre left likes the notion of citizenshipbecause it speaks to the ‘higher’ side of people’slives – their participation in democracy and thepursuit of equity. Research has shown that about77 per cent of people see the NHS as a universalservice, that should not be just for the poor.5 TheInstitute for Fiscal Studies found that support foruniversal public services did not fall even amongthose who had opted to pay for private provision:by and large they still agreed with the ideal ofuniversal public services.6 People seem torecognise that the quality of public services theyget cannot be detached from the experience otherpeople get: they are in it together. That is whydemocratic decision-making over collectiveprovision makes such sense.

Yet citizenship cannot, on its own, provide a


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good guide to how public services should beorganised day by day. Users of public services donot want a ‘voice’ in their management orperiodic opportunities to have a say on howpublic funds should be spent. They want a goodservice, which is efficient, responsive to theirneeds and treats them with respect.

No amount of talk about citizenship willempower consumers in their day-to-dayengagement with public services. Nor does itprovide public sector managers with a clearenough sense of purpose in deciding how to runservices. Leading Labour-controlled councils,such as Gateshead, which displays a powerfulsense of civic purpose embodied in the BalticFlour Mills Centre for Contemporary Art forexample, also have highly developed programmesto focus on customer satisfaction. Managers inhospitals, libraries, schools and police stationsneed a tangible set of goals linked to what usersneed, here and now. Users want better services,not more meetings at which they can discussplans for better services. As Tom Bentley puts it:

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We would be optimistic in the extreme tothink that simply applying time-honouredmethods of formal representation andvoting to a wider spread of institutions islikely to engage a critical mass of thepopulation. The logic is that police forces,schools, councils and so on could becomemore visibly responsive, and that moredirect participation in deliberating over thecomplexities of public decisions wouldspread a new found appreciation for publiclife among a currently disengaged public. Asa sole basis for political renewal, this is aslender hope.7

Voice for users – the more direct, informal,immediate the better – is a vital component inpublic service reform. But citizenship – formaldemocratic representation – cannot be the soleorganising principle for public service reform.Instead, we need an approach that gives people adirect voice through the way in which everydayservices are actually developed and delivered.


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6. Personalisationthroughparticipation

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Personalisation through participation makes theconnection between the individual and thecollective by allowing users a more direct,informed and creative say in rewriting the scriptby which the service they use is designed,planned, delivered and evaluated. In the case ofAnne Rhodes and other emerging examples ofparticipative services, this invariably involvesthese steps:

� Intimate consultation: professionalsworking with clients to help unlocktheir needs, preferences and aspira-tions, through an extended dialogue.

� Expanded choice: giving users greaterchoice over the mix of ways in which

their needs might be met; to assemblesolutions around the needs of the userrather than limiting provision to which-ever institution in question – the school,hospital, social services department –the user happens to be closest to.

� Enhanced voice: expanded choiceshould help to further unlock theuser’s voice. Making comparisonsbetween alternatives helps people toarticulate their preferences. This isvery difficult to do from a blank sheetof paper. Choice helps to unlock voice.

� Partnership provision: it is onlypossible to assemble solutionspersonalised to individual need ifservices work in partnership. Aninstitution – for example a secondaryschool – should be a gateway to arange of learning offers provided notjust by the school but by other localschools, companies, colleges anddistance learning programmes.


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Institutions should be gateways tonetworks of public provision.

� Advocacy: professionals should act asadvocates for users, helping them tonavigate their way through the system.That means clients having acontinuing relationship withprofessionals who take an interest intheir case, rather than users engagingin a series of disconnected trans-actions with disconnected services.

� Co-production: users who are moreinvolved in shaping the service theyreceive should be expected to becomemore active and responsible in helpingto deliver the service: involved patientsare more likely to attend clinics,students to do homework.Personalisation should create moreinvolved, responsible users.

� Funding: should follow the choicesthat users make and in some cases –direct payments to disabled people to


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assemble their own care packages –funding should be put in the hands ofusers themselves, to buy services withthe advice of professionals.

Users should not be utterly dependent upon thejudgement of professionals; they should be able toquestion, challenge and deliberate with them. Norare users merely consumers, choosing betweendifferent packages offered to them; they should bemore intimately involved in shaping and even co-producing the service they want. Through partici-pation users have greater voice in shaping theservice, but this is exercised where it counts,where services are designed and delivered.

Service users can only change their role in theservice script, however, if professionals altertheirs. Professionals have to become advisers,advocates, solutions assemblers, brokers. The roleof professionals in participative services is oftennot to provide solutions directly, but to helpclients find the best way to solve their problemsthemselves.


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Can personalisation provide anorganising principle for public servicereform?Table 1 compares how personalisation wouldprovide a new organising ideal for public services,in contrast to traditional public sector manage-ment and new public management, whichbecame fashionable in the 1980s, with itsemphasis on contracted services.

There are important public services wherepersonalisation will not make sense. Someoneentering an accident and emergency departmentdoes not want a dialogue, they want quick,competent treatment. Defence, traditionallyconceived, is not something that can bepersonalised, although the public has a vital roleto play in the fight against terrorism, for example.

Personalisation will make sense most inservices which are:

� Face to face: education, non-emergency health care, social services,housing


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Table 1 A new organising ideal for public traditional public sector, new public

Traditional public sector

Public interest Defined by politicians and experts

Performance objective Manage inputsGood administration

Accountability Upwards through departments to politicians

Delivery model Public institutionsProfessional self-regulationHierarchical departments

Ethos Patrician public servicesTechnocratic


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services: comparison betweenmanagement and personalisation

New public management Personalisation

Aggregate customer Dialogue between preferences/customer providers, funders and users surveys at all levels

Inputs and outputs Multiple agreed with managed for efficiency stakeholders, users including

user experience and socialvalue

To politicians and users To users directly as well as through market taxpayers, stakeholders and comparisons and politicianscontracts

Contracted services Mixed market of providers.Solutions assembled from a variety of sources around user needs

Market-based Democratic, personalised,user-centric

continues overleaf


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Table 1 continued

Traditional public sector

Users Deferential

Manager’s goals Satisfy political masters,professional self-regulation

Private role Minor, kept separate

Professional role Decide and allocate resources

Classic organisational Reithian BBCform The central Civil Service

Source: Adapted from Creating Public Value, Strategy Unit.


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New public management Personalisation

Consumers, some Co-producers, creating self-service solutions with professionals

Meet contracted User satisfaction, wider performance targets social benefits

Major role in service Public good comes from delivery combination of public and

individual initiatives

Commission and monitor Advise, broker, advocate,solutions assembler

Wandsworth Council SureStart, welfare-to-work,1980s Next Steps direct payments to disabledAgencies

� Services based on long-termrelationships between users andproducers, rather than a set oftransactions, for example themanagement of a chronic disease

� Services that depend on a directengagement between professionalsand users where the user can play asignificant role in shaping the service.

A good example is health care, where surveysshow 80 per cent of patients want moreinvolvement in decisions about their treatment,particularly in the long-term treatment ofconditions such as diabetes. In one study of twogroups of 100 diabetics, those with traditional,professionally administered care were far morelikely to have crises and require hospitaltreatment than those who were trained to self-manage their treatment and self-monitor theircondition. Almost 70 per cent of those dependentupon professional help had crises, compared withonly ten per cent of the self-managers. The


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Department of Health estimates the averagediabetes sufferer sees a doctor for perhaps threehours a year and provides thousands of hours ofself-care. Spreading the capacity for self-care willdo more for diabetics than increasing the numberof doctors. As the population ages and chronicand long-term conditions become more prevalentit will become more important to create a widelyand equitably distributed capacity for self-management, at home.

‘Personalisation through participation’ inpublic services means users having a far greatersay in writing the scripts for how their services aredelivered, so that they have some say about theorder in which things happen, how the storymight branch, take different routes and end. As aresult the users are more involved but also morecommitted and more likely to take their share ofresponsibility for ensuring success. At the sametime, professionals are able to apply expertknowledge or evidence in far more flexible, ordifferentiated ways – by combining differentelements of a package according to the needs and


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preferences of the user, which are much clearerand more explicit as a result of their involvementin the process.

One of the largest applications should be ineducation. Personalised learning would providechildren with a greater repertoire of possiblescripts for how their education could unfold. Atthe core there would still be a common script –the basic curriculum – but that script couldbranch out in many different ways, to have manydifferent styles and endings.

The foundation would be to encouragechildren, from an early age and across allbackgrounds, to become more involved in makingdecisions about what they would like to learn andhow. The more aware people are of what makesthem want to learn, the more effective theirlearning is likely to be.

Young people are far more avid and awareconsumers than they used to be. This culture isbound to have an effect on how they vieweducation. Many secondary school age childrennow have mobile phones for which they can get


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24/7 telephone support, different price plans,equipment and service packages. They are used toa world in which they can search for, downloadand share digital music on the internet. Childrenhave quite different kinds of aptitude andintelligence, which need to be developed in quitedifferent ways. The school system alreadyrecognises that some children have ‘special’ needsand so need personalised kinds of learningenvironments and teaching styles. But up to nowthe system as a whole has been unable to deliverthis flexibility consistently for all those who needit, or to integrate children with special needs intothe ‘mainstream’. Personalised learning wouldextend this principle, already implicit in thesystem, to all children. Equity cannot be handeddown from on high in a society with a democraticculture in which people want a say in shapingtheir lives. Comprehensives promoted equitythrough common standards. ‘Personalisedlearning’ allows individual interpretations of thegoals and value of education. Children should beable to tell their own story of what they have


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learned, how and why, as well as being able to reeloff their qualifications, the formal hurdles theyhave overcome. Their personal involvement inmaking choices about what they learn, how andwhat targets they set for themselves, would turnthem into more active learners.

Personalised learning does not apply marketthinking to education. It is not designed to turnchildren and parents into consumers of educa-tion. The aim is to promote personal develop-ment through self-realisation, self-enhancementand self-development. The child/learner shouldbe seen as active, responsible and self-motivated,a co-author of the script which determines howeducation is delivered.

The traditional script, largely written byproducers and regulators, is that educationproceeds through a series of stages, which set therhythm for how people learn, at what pace and towhat end. In many ways the standards agenda ofthe 1990s has made these scripts more uniform –the literacy and numeracy hours in primaryschools – for example.


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Personalised learning would start from thepremise that learners should be actively,continually engaged in setting their own targets,devising their own learning plans and goals,choosing from among a range of different ways tolearn. Experiments with pupil self-assessment andtarget setting – for instance at Nine Stiles, acomprehensive school in Birmingham – showthat pupils do not set themselves targets that areeasy to reach. They tend to set realistic butstretching targets.

New approaches to assessment, for example‘assessment for learning’, help learners work outhow effective their learning was, what workedwell or badly for them. That allows students toadjust and adapt their learning strategies.Traditional assessment tests the extent ofsomeone’s knowledge at the end of a period oflearning and provides the learner with littleinformation about which learning strategies weremore effective. Personalised learning would onlywork if students were engaged in continual, self-critical assessment of their talents, performance,


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learning strategies and goals. Personalisedlearning would allow and encourage learning totake place in holidays and outside normal schoolhours. It would make opportunities to learnavailable whenever the learner wanted to takethem up. Children would be able to take time outfor other activities that might add to theirlearning: voluntary work, drama and sports. Thisflexibility might be based on the principle of‘earned autonomy’; children who clearly do welland are self-motivated become more self-regulating. Students should have a choice – underearned autonomy – about where learning takesplace: at home; at an individual school; movingamong a network of schools; virtually throughICT in school, at home or in a third space such asa library; in situ at a workplace or voluntarygroup.

This implies far-reaching changes in the rolesof professionals and schools. Schools wouldbecome solutions assemblers, helping children getaccess to the mix and range of learning resourcesthey need, both virtual and face to face. Schools


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would have to form networks and federationswhich shared resources and centres of excellence.An individual school in the network wouldbecome a gateway to these shared resources. Whatdoes this mean for funding of education? Shouldeach school get a set sum per child? Should themoney follow the student? Should all studentshave an amount they can spend on learningmaterials from outside the school? All theseoptions have complications. Yet if money doesnot flow with student choices then the system willnot be truly responding to learner demand.

A mass, personalised learning service would bea revolutionary goal. By giving the learner agrowing voice, their aspirations and ambitionswould become central to the way services areorganised. At the moment, at the heart of thesystem are its institutions and professions –schools and teachers – that lay down whateducation is and how it should proceed. Studiesof performance management across a wide rangeof organisational fields show that productivityinvariably rises when people have a role in setting


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and thus owning their targets. The same is truefor learning.

ObstaclesThe biggest challenge to the personalised servicesagenda is what it means for inequality. Take thecase of personalised learning. Middle class homesare often far more conducive to personalisedlearning than many poorer homes that have lessspace, fewer computers and books. Thus the morethat personalised learning promotes self-provisioning, the more it could wideninequalities. As more learning would be done inthe pupil’s own time, the state will have to workharder to equalise the conditions for learningoutside school. Personalised learning willpromote equity only if the resources forindividualised, home-based learning are alsomore equally available. Personalised learningencourages us to focus on the totality of resourcesavailable for learning, at home and at school.

Middle class children do not just have moreresources for learning, they and their parents


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probably have more time and capacity to makechoices about education. Choices are made in asocial context of peer and family influences. Ifthese mitigate against learning – for example ifparents had a negative experience of school, orelder siblings left school with few qualifications –then providing kids from poor, chaotic ordisrupted families with more choice may notencourage them to consider different choices.Culturally and emotionally nourished childrenwill see huge opportunities in personalisededucation; those who do not come from thesebackgrounds may not recognise the choicesavailable to them.

The more that health and education outcomesdepend on individual and private initiative, evenwithin a public framework, the more thosealready well off are likely to benefit. Four in fivedeaths are due to circulatory disease, cancer andrespiratory illnesses, in which lifestyle – diet,exercise, smoking and drinking – are the mainfactors. Middle class people with financial, socialand emotional resources find it far easier to


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change their life style than poorer people wholack these resources. Public policies that dependon users making an investment of time and effort– such as smoking cessation – will favour thosewith relatively stable lives. It will be lessfavourable for those with chaotic or impoverishedlives, people who struggle to get from one day tothe next.

That is why the rate of smoking is decliningfastest among the most well off and bettereducated: these are the people who are more likelyto have the information, incentives and resourcesto change their lives. In contrast, 70 per cent ofsingle mothers smoke. Smoking is a major causeof ill health and a drain on the public good: itcosts the NHS more than £1,500 million a year totreat smoking-related disease. No public servicecan ‘deliver’ non-smoking. The decisions to startand stop smoking are made by individuals in thecontext of a wide range of factors, among thempeer influences, advertising and emotional stress.To reduce smoking from 25 per cent of thepopulation to, say, less than five per cent, would


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only be possible with a public policy thatpersuaded millions of people to change their lives.Public values would have to infiltrate the privatedomain. Yet because the capacity to make thesechoices is unequally distributed, so too are theoutcomes. Smoking is increasingly concentratedamong poorer people, while ex-smokers are morelikely to be better off and better educated.

The more that services become personalised,the more public resources will have to be skewedtowards the least well off to equalise oppor-tunities. Well educated and informed consumersare already well prepared to take advantage ofchoice. The least well educated, informed andambitious will need additional help to exploit theopportunities personalisation makes available tothem.

These concerns should strongly influence howpersonalised services are designed and resourced.The role of professionals as advocates, advisers,brokers and solutions assemblers will be vital tomediate the individual’s relationships with theservices he or she needs. The people who most


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need bespoke, labour-intensive and personalisedservices are the most vulnerable, who are oftenserved by multiple, poorly coordinated publicservices. Single mothers, children at risk, frail andelderly people should all have personal advocatesto help them assemble the solutions they needfrom among the panoply of public service.

Moves towards user involvement and co-production are more effective when they follow afew simple rules:

� Set incremental goals, starting smalland manageably.

� Specify clearly what the user and theservice professionals expect to do.

� Keep joint records of achievement andperformance to reinforce success.

� Give users a mix of options throughwhich they can achieve their goals.

� Frame the policy in an aspirationalway to excite ambition.

� Provide role models and peer-to-peersupport to build confidence.


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With careful design personalised services neednot widen inequalities. On the contrary theycould be most valuable for people in most need.


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7. The politics ofpersonalisation

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A chasm has opened up between people and largeorganisations, both public and private.

Many people’s experience of being a consumeris that they are put on hold, kept at arm’s length,not told the whole story, tricked by the fine print,redirected to a website and treated like a number.We feel detached from large organisations – bothpublic and private – that serve us in increasinglyimpersonal ways. While choice among com-modity goods and services has expanded, thescope for personalised, human service, tailored toour needs, seems to have declined.8

This gap between large organisations and theintricacy of people’s everyday expectations andaspirations, is a breeding ground for a growingsense of frustration and resentment, with privateservices as much as public. This chasm should

also be the breeding ground for innovation andexperimentation. That is what personalisation isabout: finding innovative ways to reconnectpeople to the institutions that serve them.

This chasm between people and institutions iscentral to the future of the public sector. Peoplemay feel closely connected to and well served bytheir teacher, doctor or postman. But they oftenfeel distant from the school system, the healthsystem or the Post Office, which they see asbureaucratic and impersonal.

The debate about the future of public servicesis pitched into this chasm between the way publicinstitutions work and how users experience them.Targets, league tables and inspection regimes mayhave improved aspects of performance in publicservices. Yet the cost has been to make publicservices seem more machine-like, more like aproduction line producing standardised goods.

Public service users should have a voicedirectly in the service as it is delivered. That voicewill be unlocked only if they also have a degree ofchoice over when, where, how and to what end a

The politics of personalisation

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service is delivered. The aim of personalisedpublic services is not to provide the self-interested, self-gratification of consumerism butto build a sense of self-actualisation, self-realisation and self-enhancement. The morepeople are involved in making decisions aboutservices, the more knowledgeable they become,and the more responsible and committed theybecome to making sure the service is a success.

Personalised services should bring wider socialbenefits. Users who are asked to consciouslycommit to goals related to a service are far morelikely to stick with it, attend appointments andclasses. One crime study, for example, found thatpeople were 400 per cent more likely to interveneto stop a crime if they had pre-committed to lookafter the property involved. Home-schoolcontracts work on the same principles. Involvedusers are likely to be more committed to asuccessful outcome and they are more likely tobuild up their own knowledge. That in turn couldmake them less dependent upon professionalsand so less demanding. That should be good for


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users but also for professionals who can directtheir attention elsewhere.

Across a range of activities it is increasinglyclear that the state cannot deliver collectivesolutions from on high. It is too cumbersome anddistant. The state can only help create publicgoods – such as better education and health – byencouraging them to emerge from within society.This is true for health, education, communitysafety, neighbourhood renewal and a range ofother public goods.

Crime and antisocial behaviour are stronglyaffected by the values and behaviour ofindividuals, families and communities, while onlymodestly affected by the activities of the policeand courts. In education, research suggests thatvariation in educational outcomes is explained bywhat happens at home, as much as what happensat school. More sustainable use of resourcesdepends on changes in consumer behaviourthrough energy efficiency, recycling and reuse.The tax system increasingly depends on massinvolvement in self-assessment and reporting.


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Three million people in Britain are seriouslyunderproviding for their pension and betweenfive million and ten million more are not savingenough. The state cannot change their behaviourthrough dictat nor can it solve the problem with abetter state pension. A collective solution topensions provision will require self-regulation,new products and services and millions of peoplebeing encouraged to choose different ways to savefor the future. Welfare to work and active labourmarket programmes are premised on the user asan active participant, who takes responsibility forbuilding up his or her skills and contacts.Neighbourhood renewal has to come fromwithin; it cannot be delivered top-down from thestate. Most community regeneration programmesnow involve local residents as participants in theprocess – designing and delivering change. Homecare services are increasingly designed toencourage and enable elderly people to stand ontheir own two feet, cook, clean and look afterthemselves rather than provide them with a long-term service.


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Participative approaches to service design anddelivery create public value by recasting therelationship between the individual and thecollective, the public and private. Public policy ismost effective when it harnesses and shapesprivate activity rather than supplanting it,allowing the public good to emerge from withincivil society. Personalised services are one point ina range of different ways in which public andprivate work together to create the public good.The state’s job will be to orchestrate and enablethat process, not to pretend it can provide ordeliver solutions in the form of discrete services.

In more areas the onus will be on changes toprivate behaviour which cumulatively createpublic value. Anti-smoking policy is a goodexample. Smoking causes about a third of allcancers, about one-sixth of heart and circulatorydisease and more than 80 per cent of serious lungdisease. The indirect social costs of smoking – lostproductivity, pain, loss and harm to non-smokers– has never been established. About 83 per cent ofsmokers say they would not smoke if they could


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have their time again. Promoting smokingcessation is a clear public good. Public policyplays a critical role in making smokingunattractive – through increased taxation, anti-smoking campaigns, restricting advertising,public information and courses which helppeople stop smoking. Public policy is in directconflict with commercial interests which promotesmoking at the cost of wider society. Smokingcessation cannot be delivered like a takeawaypizza. The public good – fewer people smoking –will come about through millions of individualdecisions. The public good will be built bottom-up. It will come from public values and normsinfiltrating private decision-making.

In other cases the public sector might provide aplatform for private action.9 There is nothing newin this. Much of nineteenth-century city govern-ment was designed to allow the public good toemerge bottom-up from within society. A primeexample was the Penny Post created in 1837. ThePenny Post was made possible by a dramaticexpansion of the public sphere. It led to houses


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being numbered and streets named, throughwhich people could be identified with theiraddress. Yet this public and standardised systemfor assigning names to addresses also led to adramatic expansion in private activity as peopletook up letter writing. Private communicationgreatly expanded on the basis of the publicplatform. Another example was the introductionof city maps in the nineteenth century. Beforethese maps were available cities were small andpeople navigated their way around by word ofmouth and local knowledge. Maps provided anobjective, standardised account of the city’sshared public space. Yet maps were alsosimultaneously private tools for people tonavigate their way around for their own purposes.Much the same could be said for water andsewerage systems and public libraries. The Britishstate has been at its most effective when socialreform has allowed public and private to expandtogether, with public platforms creating the basisfor a complementary expansion of privateendeavour.


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More personalised solutions, in which the usertakes responsibility for providing part of theservice, should enable society to create bettercollective solutions with a less coercive, intrusivestate, a lower tax burden, a more responsible andengaged citizenry and stronger capacity withincivil society to find and devise solutions toproblems without state intervention.

The logic of personalisation, if carried into theheart of public organisation, will have far-reaching consequences.

The chief challenge facing government in aliberal, open society is how to help create publicgoods – such as a well educated population, withan appetite to learn – in a society with ademocratic ethos, which prizes individualfreedom and wants to be self-organising and‘bottom-up’. Government cannot decide on itsdefinition of the public good and impose it fromabove, at least not continually. It cannot simplyregulate smoking, poor reading and bad eatinghabits out of existence. Nor can it stand back andaccept whatever emerges from complex, self-


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organising systems, such as education and health,in which there are many relatively autonomousplayers. The British secondary education system,if left to its own self-organising devices, wouldlikely entrench underachievement and lowaspirations, as well as provide some with greateropportunities for learning.

The English state in particular is caught in abind: committed to protecting, even expanding,the sphere of private freedom it also is necessarilycommitted to shaping, continuously, how peopleuse their freedom in the name of the public good.In an open, self-organising society, governmenthas to become molecular: it has to get into thebloodstream of society, not impose change ordeliver solutions from without. Government isexercised in a myriad of micro settings, and oftennot just by state employees but by teachers,experts, advisers, parents, volunteers and peers.Most of the work of government is not conductedin departments in Whitehall but at thousands ofpoints scattered across society.

The challenge then is not just to personalise


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services but to shift from a model in which thecentre controls, initiates, plans, instructs andserves, to one in which the centre governs throughpromoting collaborative, critical and honest self-evaluation and self-improvement. Reforms topublic services should drive in this directionpromoting new sources of information for users,creating new interfaces such as NHS Direct forthem to access services and get advice, providingprofessionals with the skills and support tobecome brokers and advisers as well as solutionsproviders, changing funding regimes to give usersmore influence over how money is spent on theservices they consume, giving users a right to avoice in the design of the services they use.

A state that is committed to protecting privatefreedom must also continuously shape howpeople use their freedom in the name of the widerpublic good. Personalisation through partici-pation is part of the solution to this dilemma ofhow to rule through freedom, to allow the publicgood to be created within society rather thanrelying on the state to deliver it.


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Notes

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1. Anne Rhodes’ story and seven other case studies ofpublic services innovation are told in C Leadbeater, TheMan in the Caravan and other stories (Hayes, Mddx:IDeA Publications, 2003).

2. For further reading on scripts, services and innovationsee B Nooteboom, Learning and Innovation inOrganisations and Economies (Oxford: OxfordUniversity Press, 2001).

3. See G Kelly and S Muers, Creating Public Value: ananalytical framework for public service reform (London:Strategy Unit, Cabinet Office, 2002), available at:www.strategy.gov.uk.

4. Speech on 12 Dec 2003 to launch of The Adaptive State:strategies for personalising the public realm (London,Demos, 2003).

5. See Creating Public Value, Strategy Unit.6. D Halpern and C Bates with G Beales and A

Heathfield, Personal Responsibility and ChangingBehaviour: the state of knowledge and its implications forpublic policy, discussion paper (London: Strategy Unit,Cabinet Office, 2004).

7. T Bentley, The Self Creating Society (Renewal, 2004),available at www.renewal.org.uk.

8. J Maxmin and S Zuboff, The Support Economy: whycorporations are failing individuals and the next episodeof capitalism (London: Allen Lane/Penguin, 2003).

9. See P Joyce, The Rule of Freedom: liberalism and themodern city (New York: Verso, 2003); and N Rose,Powers of Freedom: reframing political thought(Cambridge: Cambridge University Press, 1999).


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