Mark Drakeford examines the parallels between the 'customer' experience in the healthcare system and the fate of his beloved Glamorgan County Cricket Club.
Mark Drakeford is a Professor of social policy and applied social sciences at Cardiff University. For ten years he was the Cabinet’s social policy adviser at the Welsh Assembly Government and, latterly, head of the first minister’s political office. He is now the prospective Labour candidate for the Cardiff West consituency, following Rhodri Morgan’s decision to retire from the Assembly.
I want to reflect on two different experiences of the last week, and the lessons which might be drawn from them for policy making in Wales. At first glance, they appear to be very different, but my argument will be that there are overlaps and synergies to be drawn from considering them together.
The first event is the visit to Wales, over the last week, of Edgar Cahn, a name which may not be familiar to many readers. The second is the crisis which continues to grip Glamorgan County Cricket Club.
Edgar Cahn began his career under the Kennedy White House, working both as a speech writer and civil rights lawyer for Bobby Kennedy in particular. Over the past 15 years his invention of ‘time-banking’ has spread to 33 different countries around the globe, and has found an especially receptive audience in Wales.
Cahn’s work focuses on communities where money is in short supply, but where skills and abilities are abundant. In the place of money, time is used as a currency to allow local economic exchanges to take place.
My focus is more on the radical critique which time-banking provides for traditional welfare services. Cahn argues that, far too often, there has been a very unequal and one-sided relationship between professional workers and those who use their services. Starting from a set of entirely laudable intentions – to provide relief to those in distress, to provide certainty of help in times of trouble – services have failed to understand that those who use services are assets in their own right.
Future services, time-banking suggests, have to be based on a clear understanding of people as assets – each with something unique to offer. On that basis, the encounters between providers and users of services are transformed from ones in which users are the passive objects of others’ concerns, into reciprocal, and mutually respectful relationships, in which the expertise of user and provider are seen as equally valuable and equally necessary.
The extent to which services are valued, owned and defended, then, depends on the quality of the human encounters around which they are provided. Public ‘ownership’, in this conceptualisation, is far more than some remote and impersonal idea of social policy text books. It is part of the lived experience of being part of a common endeavour, in which users are valued for what they can contribute – what they give, as well as what they need and receive from others.
These are issues which came to the fore in the experience of ‘customers’ treated at the early, private-sector Independent Sector Treatment Centres (ISTCs) in England where users reported mixed views. On the one hand, they were highly appreciative of having their conditions treated quickly and successfully. Being out of pain was not a benefit which patients treated lightly: it really mattered.
However, the experience of treatment in a ‘hip factory’ was an unhappy one. Its impersonal nature, the sense of being just one more item passing along a surgical slab was, to deploy a term used by recipients, ‘demeaning’. You went home physically restored, but civically diminished. Bright new buildings, shiny new sheets did not, in the end, compensate for the absence of any sense that this was a system which had any direct personal care for you, as an individual person.
Time-bank theorists can apply this experience to the current enthusiasm for the ‘great society’ which appears to grip those now in power in Westminster and Whitehall . Their central message to users of public services (to be seen, for example, in this week’s Department of Health policy paper on social care) is, essentially: you’re on your own – goodbye and good luck.
By contrast, time-banking does not share the view that the state is a problem, positioning it, rather, as part of the solution to social evils. Finding ways to draw out, and draw on, the contributions of services users is not part of some plan to replace nurses, or teachers or social workers.
Rather, public services are the essential bedrock from which the energy and contribution of service users can be liberated. It is by marrying together the individual human experience of reciprocity in the wider collective effort to look after one another that time-banking holds out a future for public services which unites all those involved in them as their fiercest defenders.
Turning, now, to my second experience of the last week – the unfolding crisis of Glamorgan County Cricket Club. I’ll spare you the reminiscences of someone who, in the Australian phrase, is in danger of being ‘cricket tragic’. I won’t tell you of how, as a small child, I was taken by my father to see the last day of first class cricket ever played at Stradey Park, to watch (in my memory at least), Jeff Jones bowling to Trevor Bailey (even middle-aged readers may wish to consult the reference books here).
However, I will admit to having been a Glamorgan member, continuously, for more than forty years. Anyone who has watched the club over that period will know that membership has to be good for the soul. If suffering in this world is a preparation for what follows in the next, then decades of supporting Glamorgan must be as good as it gets.
Yet, I have never, ever, wanted to support any other club. Through the lengthy not-so-good times, as well as those occasional triumphs, my summers have been dominated by turning on the radio to hear the score, in Welsh and in English from Alun Williams, and Edward Bevan and by sitting on some of the most uncomfortable chairs in the County Championship. It was, I knew, where I belonged.
Now, I go to a much smarter and far better appointed Sophia Gardens – sorry, Swalec Stadium. The state of the ground is state of the art. The facilities for players are amongst the best in the land. Yet, the experience, is akin to a cricketing ISTC. The ground is, as the chairman (and he is, of course, a chairman), a conference centre with a cricket field attached.
The atmosphere is barren. To set foot on the grass itself is to invite the descent of a posse of walkie-talkie toting attendants. To bring a child into the ground is to commit a solecism akin to entering the Members Room at Lords wearing only a wide smile and a bikini.
And now, there are to be no players either. I don’t write here in the belief that no criticism of any sort could have been levelled at the outgoing trio of captain, coach and overseas player. I am sure that the means of their going has been a sorry tale, brought on by a fundamental failure to grasp what actually matters to Club members. Any Club of which Peter Walker is not prepared to be President has lost its way very badly indeed.
So here is where my twin themes come together. Time-banking teaches us that support for services depends upon a sense of ownership, derived not from the efficiencies of calculating machines, or the metallic shininess of new buildings and equipment but from the quality of human encounters. These are encounters, moreover, based on reciprocity – a sense that users have something to contribute, and a voice which must be heard. Apply this to the collapsing sense of morale (and quite possibly membership) at Glamorgan and it can be seen just how wrong has been the road followed by those in charge.
What makes Glamorgan a club which is followed through the length and breadth of Wales is the sense that it offers a relationship between each of its followers and its activities on the field. Through triumphs and disasters we feel that what goes on matters to us, and that we matter to the club. As in ISTC patients, I don’t want to have to choose between decent facilities and a sense of ownership, but if I had to, I’d take the second every time.
When I’m offered a comfortable seat in a stadium where I don’t feel welcome, and that my membership counts for very little, then I’m much less likely to be willing to rally round when times are tough. It seems to me to be exactly the sort of lesson which public services in Wales need to learn, and to avoid.Like this article? Sign up to Left Foot Forward's weekday email for the latest progressive news and comment - and support campaigning journalism by making a donation today.