Ravi Gurumurthy: Hello and welcome to The Mission. This is the podcast to listen to if you’re interested in mission driven innovation. My name is Ravi Gurumurthy and I’m the Chief Executive of Nesta, the innovation foundation. And on this podcast we’re going to be talking to practitioners, academics and policymakers about how to tackle society’s intractable challenges.

With me today is Hilary Cottam, who I struggle to categorise. She’s been described as a designer, inventor, social entrepreneur, and she’s certainly an author, an author of a great book called ‘Radical Help: How We Can Remake the Relationship Between Us and Revolutionise the Welfare State’. And the mission that Hilary is on is creating a new social settlement and that’s what we’re going to be discussing today.

Hilary, welcome to the podcast.

Hilary Cottam: Oh, it’s a pleasure to be with you, Ravi. Thank you for asking me.

RG: Well, thank you for coming on. I want to start actually by asking your inspiration. So who and what inspired you on the mission that you’re on?

HC: Okay, well maybe I can answer that question on two levels. So I think one thing that has framed my whole working life is an experience I had quite early on of going to live in a barrio in a sort of urban settlement in the Dominican Republic where I had previously worked. I’d previously gone there with the government, with an NGO running focus groups and doing participatory work, asking all sorts of things about education and health. And then I went there without any agenda to live with the people and I discovered that the reality of what was, for example, framing school attendance or determining health was so very different to anything I’d been told when I’d gone with my sort of official hat on that I knew I needed to start again and learn to work in a completely different way if I was going to be part of any effective social change. So that’s sort of a kind of very broad framing, but thinking very particularly about the social settlement and our need now for a social settlement, of course I’m very inspired by William Beveridge really, who was the designer of our existing welfare state. I think he’s really important because he had such a big vision of what could be at a very difficult time. He started working in the recession of the 1930s, of course the welfare state was put together in bombed out cities after the Second World War, and yet he and his contemporaries really dared to dream big. And on the innovation side of course, they began to put into practice policies that they had experimented with and grown through practice sort of 30 years earlier. So I think he is really important in terms of the very big vision and making deep social change at a time of kind of great trouble.

RG: And in your book you talk a little bit about Beveridge’s lesser known third report where he starts talking more about voluntary action and you suggest that by that time he’d become aware that maybe he’d become, or he’d over-emphasised the role of the state and underplayed the importance of family and social connection. Can you just say a little bit more about that?

HC: Yes. I mean of course Beveridge was a very complex maverick figure, but his very famous eponymous first report, The Beveridge Report, is of course the blueprint for the welfare state, and then he wrote this third report – he wrote a second one on employment – and a third one in which he looked at voluntary action. And this third report was much less read. It was a collaboration with the voluntary sector who in fact sort of fell out amongst themselves because they were so anxious to push their own personal agendas rather than think about what was happening with the welfare state, which is something that we might think is also not uncommon in our times. But what he said was, he was very worried. He had not foreseen that the state would deliver all services, and he hadn’t actually foreseen - which I think is really important for this conversation – that the welfare state would be reduced to a conversation about services. He’d been thinking much more broadly about what is needed to flourish and how people could help each other, how services do play a role, and what he saw was that people, communities, had been squeezed out. And most importantly, that what he had designed needed to evolve and without that lived experience, without that knowledge, without that imagination, things were already becoming stuck.

RG: So we’ll get into that richer notion of a welfare society quite a lot during this podcast. I just want to start with the diagnosis and your picture of how the welfare state works now, and I think you paint a picture of lots of gatekeeping, lots of assessments made, referrals, but never actual help and it’s quite a transactional picture that you paint between state and citizen. Can you just give us some practical examples of where you think the current system is falling short?

HC: Yes. I mean can I just say I don’t think ‘never help’, I think that the welfare state is full of amazing professionals who do offer help, but they have to do it against those rules and transactions, sort of almost in spite of the system. So I mean my diagnosis is that we are in a time of fundamental transmission, and this was even before COVID, influenced by technology in particular which has caused deep social change and economic change. So I think the first thing is that the big challenges we have today were not foreseen when the welfare state was designed. So a very good example would of course be the brilliant fact that we’re living longer, which is something to celebrate, but if we think about care systems in a very kind of rigid 1950s bureaucratic way, of course they don’t function. If we think about health, who creates health? Communities create health, not hospitals. Today most of us will be living by the time we’re in our sixties with one to four chronic conditions. We know that this is what most impacts on our health services, and yet they were designed to cure infectious diseases. So the first thing is that the kind of problems we face are really, really different, they can’t be solved by services, they have to be solved by a combination of professional and citizen action and the welfare state is designed to keep us at arm’s-length where we can be managed. So that’s one thing. The second thing that’s really important, I think, is the way that society itself has changed. Beveridge designed around a white nuclear family in which, you know, the man would go out to work, the woman of course would pick up most of the care, which is why we don’t have good care systems. And, you know, today this has become extremely complicated, most people can’t live off one salary, we know that, you know, 40% of families are taking family tax credits even when they’re in work, women no longer want to do the work of care, they want to share it with men. And also we can talk about how ethnically our society has changed, and we’ve seen very much in this pandemic, I think it’s really brought home something that many people have known for a long time, which is that if we treat everybody equally we’re actually not supporting people in the way they need to be supported. So the sort of context in which the welfare state is operating has massively changed.

RG: I mean it’s absolutely true that the context has changed, but some of the original policy intent from many, many years ago, if you take the Seebohm Report in 1968 that really created integrated social services departments, some of the wording in that is very similar in a way in terms of the ambitions that you have. So I’ll give you one quote, which is ‘Services for people in their own homes will not be adequately developed unless greater attention is paid to supporting the families who in turn support them. If old people are to remain in the community support and assistance must often be directed to the whole family of which they’re members’. And you talk in your book about why those policy intentions often fail to translate into action, but what do you think underpins that?

HC: Well, it’s obviously very complex and it’s been a very slow process of erosion because obviously the welfare state completely transformed the lives of British people and in its time it was adequate, more than adequate, it was, you know, exported all round the world as a hugely successful blueprint. But I think what’s happened is that those welfare services, as you said, have become very transactional, that there’s been, you know, in the 1970s a sort of compact broke down, there was a lot of worry from that point on about how things were funded. There was the beginning of a marketised approach to services. And I think the most important thing – well, there’s many things we could talk about, about what’s happened through that emphasis on the market and thinking of services as within a market – I mean how can I summarise it? Well, one of the things is that the focus has become on the services themselves. So we’ve had this, you know, we were talking about innovation today and we’ve had this emphasis on how to innovate the services. What we haven’t done is step back and say, you know, how do we create health, what do we need to flourish in this very different century. And that’s why I think Beveridge’s statements, Seebohm’s statements that you’ve just read out, still have resonance because they’re not talking about how to make an improvement in a service, they’re talking about the much bigger picture of how we support people to flourish. And that’s what we need to do, and that’s what ‘Radical Help’ is about in a way, is that stepping back and up a level and saying what’s really required now.

RG: Well, your approach is in some ways, is inspired in part by another great person, Amartya Sen, because you talk about a capability based approach to supporting health and learning and care. And just say a little bit about, again, what that means in practice. What’s an example of a capability based approach to, say, healthcare?

HC: Yes. So I think what’s really important about the work of Sen and Nussbaum is that the capability approach asks this apparently very simple question, which is what can I really be or do. And what that brings into the frame are really practical things. Do I live in a place where there actually is any good work, where there is outside space to safely play in. But also internal things, what have people told me that I can be or do, how do I see myself and how has that been influenced. So I think what’s really important about the capability approach and why I work with it is that we can hold in our minds the internal factors and the structural external factors at the same time, which we’ve sort of lost in our conversation about the welfare state. You know, we’ve begun to see it completely independent of the economy and we’ve expected welfare services to support people in places where there is actually no good work and there is no good local economy, which is of course an absurdity, it can never be a sticking plaster to that level. And then the other thing that the capability approach does is it brings into focus power. Who is defining what’s needed, who is defining how things happen. And I think that’s really important in the work I do. So one of the things, for instance, if we think about health, is that of course health is created by people in community, it’s not created by a service, and it’s an immensely complex thing about what we eat, who we relate to, what we do. And so if we think about the capability approach, we’ll start to think about health in that very sort of multiple way, bringing all those factors together. So, for example, the health service that we created, the experiment I talk about in ‘Radical Help’, was not condition specific and we sat in GP’s surgeries and we asked them to give us what they called their ‘heart sink’ patients, those patients who the doctor’s heart sinks when they walk in because they know that they can’t possibly address the kind of complex issues the person is suffering from in a ten-minute consultation. And then what we do is we sit with that person and we ask them about their lives, we don’t ask them about their health condition. And very often, the place that somebody feels empowered to start to make change isn’t anything to do with health at all, it might be- I give an example of a woman called Ann in the book who actually just wants to take up her embroidery again. But what’s important is that by starting where that person is and building the capabilities that they want to build and shifting the power and the relationship between the professional and the person and the community, actual health statistics began to improve. So it might not have looked from the outside like a – in inverted commas – ‘health’ approach, but actually health statistics began to move.

RG: But if you take sort of healthcare, or health outcomes should we say, is probably a better frame for this, is there not an argument for saying that the biggest levers are actually not in terms of the interaction with the citizen, they’re in the food that we eat and the way that our cities are planned and actually what we really need to do is tackle the obesogenic environment that promotes unhealthy food rather than really thinking about individual decisions and choices.

HC: Well Ravi, there’s a lot in your question. I mean the first thing is that I think what’s really important is that there’s no such thing as levers. And this is really the biggest shift, is that our welfare systems were designed to replicate, you know, a mechanistic 19th century industrial approach. They’re vertically organised, which is also why we can’t think about the factors you’re talking about, the obesogenic environment and so on, because they’re all about vertical organisation and vertical integration and very sort of hierarchically structured, you know, information has to move slowly up and down and then a decision can be taken. And so what’s really important now is that we have to think in kind of very complex networks and all the different dynamics together and if we start to think about which lever can we move in that context, that’s very complicated. And we all know that Tony Blair wanted to move the levers and then found they weren’t attached to anything, and that is because of the fundamental difference in the way that our society’s organised, and that, you know, leads back to the kind of original question about why do we need a social settlement, because it needs to kind of work within that context and address those problems. So of course you’re right and one of the things that would be in this social settlement is that it would operate at the level of place. It’s really important that we now rethink not around issues as such, but around place because if we’re going to tackle health then we have to think about, you know, where are the spaces to sit, how do we cycle not drive, where is access to good food, what does it cost. All of those things have to be thought about and we know that now, which is why we need to think very, very much around locality and horizontal integration in the way that we design this new social settlement.

RG: What comes through I think fantastically in some of the examples you illustrate are the role of relationships, and not just relationships between professionals and service users, but relationships between families and communities. You tell a really nice story about Stan setting up a music group and that being incredibly meaningful and valuable to him. And I just wondered about, well a few things on that. One, how valuable is it to those individuals, how do you get those opportunities to reach the most vulnerable, because we’ve seen a lot of that kind of activity actually particularly during lockdown, and also what is the role of the welfare state in actually nurturing it, or is it something that can just happen organically?

HC: Oh, that’s a big question. I mean I definitely, relationships, you know, when I work with the capability framework, relationships are one of the four capabilities I work with and to sort of use the work of Martha Nussbaum, the philosopher who was behind this approach, she talks about some things as being architectonic, that everything stands on this, and for me relationships are architectonic, because it’s not just about being able to come together – I mean you cite the music group of Stan and he was alone and then by playing music to him and a small group of people who like the same music who were able to not only sort of provide comfort, a birthday party, but then the kind of confidence to go back out the front door. So it’s about relationships at that level, about doing things with people that you really like and things that you mutually enjoy. But it’s also about an approach to how we think about how we meet people in services and in the community, that if we think about a relational approach, like how we interact with one another rather than the delivery of a service, we begin to think completely differently about what’s important, what comes first, how we speak to one another. So it’s about relationships themselves, but it’s also about the culture of relationships. So yes, very much I think that we should be able to think about that within the culture of a future welfare state and a future social settlement. And I’m not sure, in your question are you saying that it’s harder to work that way with people that you see as vulnerable, was that in your question?

RG: Well I guess I was thinking actually about what’s happened during lockdown and lots of people have been able to find their niche, with particular groups doing particular things. I don’t know whether that reaches people universally and who gets left out, and whether that just reinforces certain divides and so I was wondering about whether there’s more work to be done to make sure that the most vulnerable, the most digitally disconnected, for instance, can access those opportunities, and then what is the role of more formal services, the welfare state, in enabling or curating that.

HC: Well, it’s a brilliant question. I mean one of the things that I think’s really important that we’ve seen in this pandemic, which is also something that I’ve learnt in my work, is that people will only join things where they don’t feel that they are the vulnerable person that will be helped. So we’ve seen this really clearly now where we had, you know, an NHS volunteer service that the government asked us to sign up to and nobody used, in contrast when things were organised by WhatsApp groups at the street level, everybody got in because even if you were vulnerable and you needed help, you weren’t made to feel that you were the person that was sort of somehow, you know, lesser because you needed something. So that feeling of reciprocity, which again is a relational thing, you know, relationships are reciprocal, they’re not about doing to or feeling sorry in that, although we have empathy, that’s a different thing. So I think that’s very important and in Circle, the experiment that we designed with older people where 10,000 joined these communities where they received a different level, a different sort of support, that was really important. So we had members and helpers and one thing, for instance, there was a gender division. Men always joined as helpers because they didn’t want to say that they needed help, they wanted to say that they offered help. In fact it was a kind of, it didn’t matter, the distinction, everybody needs help at some point, and so some people are sometimes offering and sometimes receiving. But I think understanding that reciprocity is really important. When I work, I think it’s really important to design things that everybody can use, and I talk about that quite a lot, why that is important and why, you know, bridging relationships are really important. We can’t just have relationships with people that are like us if we’re going to make a society function and flourish. But what I do do is I start to design with the most vulnerable. So making sure that that is where, that’s our starting point. So I mean I always talk about, you know, social science, you know, with a bell-shaped curve. Obviously I can’t show this visually, but what generally we do with innovation is we look sort of where the numbers are and we go there. And what I do with my work is the opposite. I go right to the outsides of that curve to the most, quote, ‘difficult’, or the most, you know, unusual suspects, and then I begin to design around that and then I’ve got something that does actually work for everybody including what you’re calling the most vulnerable. I mean I’m quite uncomfortable with that because often those are the people with the most to give or whatever, but I know what you mean, just to make sure that really everybody can be part of this. And of course a lot of this has to be face-to-face. I mean I think the work I do would be impossible without a digital revolution because it sort of enables us to build very different forms of connection that take away core costs in an important way and move resource to other places. But ultimately, relationships are built face-to-face and that’s really critical.

RG: I think what you said earlier about the contrast between how the NHS used volunteers versus what happened more at a local level really resonated for me. When I think back to working with refugees at the International Rescue Committee I remember when every time Trump did something awful, there were lots and lots of volunteers signing up saying they’d like to work with our local offices around the US to try and help refugees. And frankly, we didn’t know what to do with them, and I think you often have this situation where there’s lots of volunteer effort and formal professional services don’t quite know how to manage it and make use of it. Whereas when things happen more at that local level I think it’s more possible to actually orchestrate something. What are the best examples in your work of actually trying to mobilise local voluntary effort and that working really effectively to meet particular aspirations?

HC: Well, I suppose there’s two good examples. One would be Circles, the support for older people which I’ve already mentioned. I mean by learning to build a service which didn’t mention age in any way, but by designing it so that it was something that people over the age of 50 would want to use, we suddenly had a huge membership pull, which included people in their fifties and sixties, sort of much more active and able to support people who might be more frail, as well as people sort of, you know, to their nineties. And that’s really important, because if, you know, Circle is all about on demand support for practical things, but also building friendship groups of people who like to do the same thing. And if you think about organising, let’s say, I don’t know, organising a trip to the Tate, if you’ve got sort of one person who’s perhaps, you know, not so physically able in a wheelchair in a group, the group can just manage that, they can do that themselves. If you start to think about what can we do with a very, very frail group and you’ve got ten people in a wheelchair, then that becomes very difficult to organise. So really thinking about how we integrate in a different way and build those relationships. The other thing, I mean my favourite experiment in the book is the experiment I call Backer, which is about how to find work. And so we know that most people, eight out of ten jobs are no longer advertised, most people find work and progress in work through people they know. And yet, all, you know, work support is organised around the idea that there will be an advert, you can apply for a job. I mean this government, Rishi Sunak, is just about to provide a whole set of work coaches, which will be completely useless, because really it is in those networks. So by building, building something we call Backer, which was basically about building small communities with people in work, out of work, and in between work, getting them together face-to-face, having evenings that were themed about people who liked to work with people, people who liked to travel, we began to build connections and we were able to support people into work and then support people to progress in work. And I mean I’m really bad always at remembering the data, but I mean I think we were three times as successful at a quarter of the cost or something and, you know, that was with a randomised control, randomised control trial independently conducted. So you can really, really see that if you go in thinking relationally rather than kind of with traditional stratifications, you begin to work in a different way and you have very different effects.

RG: And we’ve talked a little bit about relationships between volunteers, families, communities and individuals, but in terms of the formal services, you also touch on this in the book and it, again, it sort of reminded me of some previous work I’ve been involved in, I led something called Every Child Matters, and one of the things that we were trying to solve for was that a child who might be truanting might be in touch with the education welfare service, but they might also be neglected or abused at home and therefore might be also in touch with social services, they might also be offending and be in touch with youth justice, and they end up having lots and lots of shallow interactions with multiple arms of the state, costing cumulatively quite a lot of money, but it ends up being a very sort of ineffective service. And you talk a bit about how you could roll that up and it could become a more, could become a deeper, more continuous relationship rather than lots of these rather bitty interactions. How do you think that could happen in practice, and I did wonder about the Troubled Families programme because I think they tried to do a bit of that and I know, frankly, in Every Child Matters I’m not sure the policy intent again translated into actual action on the ground.

HC: Yes. I mean I was going to say because of course when you did that work it was so important because people really didn’t understand at that point when you did that work how fragmented it was, you know, and I talk in ‘Radical Help’ with, you know, the family with 80 people coming to visit or whatever, I mean that was unknown at that point. I mean one, just to give you a very practical example, I’m working in East Ayrshire at the moment and in Scotland there’s a Home Link service, which is meant to be an anti-truancy service that you’ll go and visit those families where children are truanting and you’ll get them back into school. And in East Ayrshire they sort of radically reinterpreted it and they’ve just said that the Home Link worker is basically there for families. Now they’ve based that work out of school so it doesn’t feel like you’re being policed and that you might, you know, everybody’s terrified of their child being taken away, so by basing somebody out of a school you lose that terror. And then these amazing Home Link workers, I mean they just turn up to make the toast and make a cup of tea and play with the younger child on the floor and build these relationships in a really, really simple way, which has had a dramatic, I mean they’ve had the biggest impact on reducing truancy, but not through talking about truancy at all, just through going into those families, building the relationships and providing the very light touch support. But it’s so interesting, because I recently wrote about this for ‘The Guardian’ and the piece went through several edits with the editor of ‘The Guardian’ saying to me the whole time, but what’s the service, what do they actually do? And so we’ve become so imprisoned in this mindset of, you know, there must be a, quote ‘service’ with a script and rules, but this sort of very light touch Home Link work is really, really having a profound effect. I mean with Troubled Families the first experiment I talk about in ‘Radical Health’ is our work with families that are suffering multiple sort of forms of crisis and have many, many interventions from social work to the police and so on. And what we did with those families was that we asked all the workers to step back and then we asked the families if they would like to choose a team to work with them according to the agenda that they set, and that created radical change in the families. So there were sort of two rules, the families would lead the programme, so it wasn’t any longer about somebody coming in and signposting you to a service, it was about sticking alongside the families with what they decided to do, and then allowing the professionals to use 80% of their time to actually support families rather than 80% of their time on kind of filling out forms and all the sort of transactional side of things that you referred to at the beginning of this conversation. And that had a very, very big impact. Of course unfortunately when Troubled Families came along and sort of made it an agenda with, you know, with a sort of cashback for whatever, that work got, I mean we stopped working because we didn’t think it should be a market, and that work got subverted. But we have got evidence that that sort of embedded way of working really works and it’s really important, that it’s exactly the same professionals, the same social workers, the same police officers, but allowed to work in a different system and allowed to work instinctively and relationally, then things really begin to shift.

RG: You talked earlier a bit about your approach to this, in particular the way you engage the unusual suspects, the extreme users, and try and design for that. Can you just say a little bit more about your approach and how it differs from how others who work on these issues solve problems?

HC: Well, I think, you know, we are a nation that, of great innovators, but I think the challenge that we have is that first of all we try to innovate within the service. So people, when I say, for instance, that, you know, you must spend time with people, people say they do that. But what that means more generally is that well, we arrive with a set of questions and we ask people, you know, how can we improve the health service. So you’re already completely trapped in a service mindset and in the reality of what you’ve got today, rather than thinking, how can I spend time with you, understand the grain of your daily life and then think about what needs to be knitted in to the grain of that life to make change. So I think that that’s really profoundly different and important. I mean it takes time, that’s also really important. And then the other thing that I would say is that if we want to shift systems we need to think completely differently about how we invest, how we start with experiments and how we grow that over time, and that is a huge challenge in this country where, you know, we love to kind of fund £50,000 projects and write them up in a report, but that’s not going to shift systems in the way that we really need in this very different context. So I suppose, I mean one thing just related back to my work, the experiments that I describe in the book, each one costs a million pounds. You know, I don’t think there’s anybody working at that scale now, but that’s what enabled us to get the data, to shift the systems, to involve everybody and allow that work to kind of really move in a different way through the system. So, for example, you know, something that people come from all over the world to visit is the Wigan Deal where, you know, they’ve done this very different deal with their citizens and really rethought the notion of service, the relationship with the community. So they’ve given assets back to the community, but not to manage because they haven’t got money, with the budgets to manage them. And I mean I can’t take credit for the Wigan Deal, I mean there’s amazing leadership and amazing people in Wigan, but we started our life work there, the family work that I referred to, and that gave Wigan, you know, something tangible that they could touch, experience something they could take people to. And then, you know, they moved that from sort of families into adults, then began to kind of grow this different approach out of something small, but really moving it from something that was, you know, an innovation project for something that has transformed the entire system.

RG: I was reflecting on your approach and also some of the innovation approaches that others have adopted in the past, and one thing I thought was interesting was that design approaches or anthropologic approaches I think are incredibly valuable, understanding the problem in a deeper way, sometimes reframing how you think about the issues or others think about the issues, but often I find it’s really helpful to have that input alongside, for instance, evidence of what works from other contexts and evidence about, for instance, how people learn. And there’s often a kind of creative tension between those and one example of that that sprung to mind when reading your book, which was when we were trying to shift how teachers were teaching social and emotional learning, the first version of what we produced was this very evidence-based content that was given to teachers, and unsurprisingly, they weren’t using it, it was totally not designed with the grain of how those teachers were working in the classroom. We then got designers involved and it was sort of radically recast, it had to be massively shortened for a start, and you have to make quite big trade-offs about what content you prioritise, but then in some ways it got distorted and the actual evidence of what works was not being applied. So we had to have a real interplay and tension between the designers and perhaps people who’ve got knowledge and expertise in the particular sector. So I’m interested in how you see that, that interplay and is that something you have in your work or do you tend to really double down purely on the sort of design and immersion in context.

HC: Well, what I’m interested in really is what allows people to talk honestly about what’s happening in their lives, because most issues of welfare are at some level shameful and generally when we meet people they are in- I mean we all need help at different stages in their lives, but generally at the point that I’m meeting people, they are at their most vulnerable and they need help and those stories are very painful to tell. So I suppose in my work I’ve been really interested in how we allow people to tell and to talk and to share. And so of course the first half of my life was working in countries in the global south and I was very influenced by Robert Chambers who had developed all these very visual methods using pebbles and sticks and drawing in the dirt to kind of begin to work in groups in a different way. I also think you have to do this work with groups of people to cross-check and validate, you can’t do it at an individual level. And then of course I found myself in Peckham and Govan with a kind of lot of pebbles in my pocket and I thought, well I can’t work like this, you know, everybody’s just going to laugh at me. So I sort of became interested in design really through the power of visual to allow people to talk about things that otherwise are too shameful to talk about. I mean there’s another level of design too, which of course is that, you know, technology is really critical and there’s this really important interface between designers and how they understand technology. But all my work is interdisciplinary. So, you know, when I’m putting together a team, designers are really important, social scientists are really important, data people are important, technology people are important, you know, perhaps a wizard to kind of change things up. So it’s not about the fact that design can make this happen, I mean design is a process and that process in my hands will be very different to that process in McKinsey’s hands. So I think it’s a really, really critical part of the mix and I liken it to a form of Esperanto, because I think the other thing it does is if- interdisciplinary work is really hard and so what you need is you need a sort of container and you need a language that’s shared that allows everybody to move forward together and allows you to listen to different things on a sort of similar level, because, you know, one of the things, for instance, in policy discussions is we can say, for instance, that economics and data is very powerful but lived experiences is much less heard and often sort of very difficult in a story so we’ll kind of iron out that bump, we’ll just keep going with the bits that look neat and then we’ll end up with some policy that has no impact on people’s lives. So I think design also can help us to bring all those perspectives to the table and really hear them, but design itself, that’s not the solution, if that makes sense.

RG: Yeah, that makes a ton of sense.

HC: Or rarely. I mean I can’t say not, but you know, rarely.

RG: Yeah. And the other question I’m sure you get asked a lot is how do you replicate and scale these things, because part of the beauty and value of your work is it’s very micro and it’s really intensively working with communities over a long period of time. So what’s your experience of trying to replicate and scale these ideas?

HC: So I write in ‘Radical Help’ about scale and I really feel, so scale is wrong, scale is over. I just think we can no longer talk about scale. And I sort of fell into that trap for a while, because people would come and look at the work and they’d so, oh this is lovely, you know, can it scale. And of course, you know, you want to prove that your work works, so you say yes, of course it can scale. And actually, you know, for instance in the work of Participle, we had a lot of success in replicating the work and I’m still working, you know, with governments in Scandinavia and so on in replicating the work. But what we’re doing is we’re taking the core principles and then we’re thinking about how do those work in this place. And I think that’s so different to scale, because scale sits in that, you know, industrial imagination I talked about which is over, it sits in the sort of, you know, any colour you want as long as it’s black, it’s all about industrial production lines, we are in a kind of digital revolution where we think completely differently about bespoke, about making, about repair. So it’s utterly different. So I think what we really need is we need to know what those principles are, and I’m really glad you asked me about capabilities because I think that is the core story. So, you know, we’re thinking about how do we create capability so that people can flourish in this century. And we know there’s a set of core things that are needed and we know that story’s really important because if you don’t have a sort of vision and a story about where you’re going then things sort of slide backwards. But then we know that if we’re doing that work in Barrow or East Ayrshire or Devon, we’re going to do it in a slightly different way. So it’s all about taking those principles and then thinking, you know, what are the materials to hand, what are the skills to hand in this place and how do we remake that. And so that is about ensuring, I suppose you could call it replication, it’s definitely about sort of a kind of generative form of growth, but it really isn’t scale which is, you know, we’ve sort of proved this in Kilmarnock, let’s take it to Barrow. It’s not that, I think those days are just over. I’ve silenced you. [laughs]

RG: You’ve silenced me because I think you’ve very elegantly reframed, elegantly got out of the question. Okay, let’s reframe scale as growth and let’s say that we want these approaches and principles to be grown so that they benefit the whole country and go nationwide, how do you actually do that without being too top-down and basically making it as industrial and Fordist as you critique?

HC: Well, I think, I mean, one, we could talk about care, because fantastically at last care is on the agenda. You know, we’ve seen, I mean everybody’s had this sort of visceral lesson in the absence of care in this pandemic, and now we’ve got a conversation, well I say now, I mean it’s a kind of recurring conversation, but how are we going to think about care. So there’s been a call for a national care service, it would be a sort of 1950s sibling of the National Health Service, and I mean that’s ironic because actually of course the other thing we’ve really seen clearly in this pandemic is how centralised institutions can’t work. I mean the NHS, we’ve celebrated it because the people who work in the NHS have done unbelievable things, but the system itself hasn’t been able to kind of get PPE and so on, you know, the centralised systems haven’t worked, in the same way supermarkets don’t work, local shops do, and so on. So I think it would be really, really bizarre and foolish to design a 1950s care service in the 2020s, but then the question comes, and that’s where your question is valid, I think, is okay, so how are we going to make sure that the citizen in Devon and the citizen in East Ayrshire is cared for, how are we going to think about something that allows for that care to be interpreted differently but we know that it’s actually there. And I think that that is about trust, it’s about saying to local places, you know, these are the principles, what’s already existing where you are in terms of sort of informal, formal, more institutional, and how can we knit that together in this place so that we are sure that we’re taking care of everyone. And that’s the journey we’ve got to go down. We don’t know necessarily how it will work, I mean the other thing that I would immediately do is I would get all those regulatory systems to be learning systems and I’d say stop sort of evaluating everybody and telling them what to do, why not go from place to place and say, you know – I keep talking about Kilmarnock and Barrow, but they’re just at the forefront of my mind – you know, in Barrow, have you seen what Kilmarnock’s doing, you know, you’re doing something amazing, and get that sharing mechanism going rather than the kind of judging mechanism going. I mean this is going to be hard and I don’t think anywhere has cracked it. But what we do see is that where small pockets of practice have knitted together, you know, I think about designing, you know, institutions like bits of jigsaw so that we have got these economies of co-operation rather than economies of scale and we can see this. I mean I’ve cited Wigan, I mean actually in Barrow there’s very exciting work happening. I mean all round the country I see this. Gateshead, for example, is another place, where they’re thinking locally about how to make this happen and how to knit it together, and it’s thinking about, those of us who are interested, how do we reinforce that, support it with, you know, knowledge, insight, money and taking away the regulatory structures. I mean again in this pandemic we have seen, you know, prototyping, if you like, in real time because the regulations disappeared and people just looked at what’s in front of them, how they can work together, and extraordinary practice has actually taken off. How we can sustain that now is the question really.

RG: So let me be selfish for one moment, Hilary, and ask you if you were actually trying to grow this new social settlement, but not in the blueprint manner that Beveridge did, but you were maybe part of an innovation foundation called Nesta, what would you be doing if you were us to try to grow this new social settlement?

HC: Yes, what a great, I mean I think that you’re so important because, you know, there isn’t much money, frankly, you know, that you’ve got this massive endowment. So I’d be saying to you, please spend that endowment, we are [Ravi laughs] in a time of – no, but I’m serious – spend it now. I mean like this is an incredible moment of seismic change, a potential paradigm change. And what I would do is I would go to place and I would look at the issues at the local level in the way that they are cost cutting and I would think about how could we build the capacity to do this work and to keep innovating at local level so that we can begin to knit together the big social problems that you’ve been talking about, you know, whether it’s health or the food supply, with the local economy and we could begin to think about how we bring together good social flourishing with good local economies, reconnect the two, but also build the innovation capacity for support at the local level. So I mean, you know, when I was running Participle with a team of 65 people, we had incredible skills which we grew at Participle. But I think, you know, now I wouldn’t be doing Participle Mark 2, I would be thinking about how Barrovians, Kilmarkians [sp?], Devonians, how we can, you know, a lot of that’s already there but more needs to grow and how can we foster that in a sort of barefoot capacity, I suppose, at the local level, and that’s what’s going to make the change. The other thing is, is that I would be funding, you know, on ten-year cycles at a serious level. Not that you kind of write the immediate sort of multi-million pound cheque, you know, obviously you look at how it goes, but I would have a serious commitment to place on a ten-year cycle, we’re trying to kind of erode 50 year old systems, and roll up my sleeves.

RG: So channelling my trustees, I think the one question they would ask is about the evidence for this approach, and I’m just interested in what we could do to actually build stronger evidence about how effective and cost effective these approaches are. Because I think if I had one quibble with your book it was probably light on rigorous evaluation, and I know you mentioned earlier on that you have done a randomised control trial of one of your programmes, I’m just interested in whether you’re interested in pushing forward on the evidence side?

HC: Well, first of all I would say to your trustees, look at the evidence of what we’ve got. But the other thing is that I think, Ravi, that there is an enormous amount of evidence for this. I mean, for instance, Nesta, who sadly never funded my work, but what they did do was that they funded independent evaluations of Circle, our ageing work, and they said they had never seen data on that level that we had collected. We collected standard outcome data, capability data and cost data, and they said they’d never seen anything like it in terms of, you know, a proven approach, and that was kind of on a sample size of about 10,000 people. So I’m just talking about my own work, but there’s enormous evidence out there. There might not be, I mean in a way it’s interesting that at the beginning of this conversation you asked me about Beveridge’s third report, because one of the, you know, Beveridge said that there wasn’t voluntary action, there wasn’t community action, and one of the criticisms that was levelled at Beveridge was there actually was, but unfortunately he wasn’t able to support it because he didn’t understand it. You know, there had been such a seismic change in how people played, how they met together that it no longer looked like something he recognised and he thought it wasn’t there, and I think something very similar is happening now with evidence. But there is a lot of evidence. It might not be that sort of, you know, very traditional data that you might be looking for, but if you go to communities you will see evidence and you’ll see evidence over the long term, which we don’t have enough of anyway, I mean we don’t have, you know, very good longitudinal data that shows what’s happening after 20 years or so. But I think we can put the evidence together for your trustees, I’m not worried about that.

RG: So, I think that’s where…

HC: We’re still learning though, of course. I think the other thing is, the other thing – can I just say – that I think’s really important about this is that I really hope, as the sort of leading innovation organisation in the country, that you’ll embrace experimentation because all the evidence isn’t there, we don’t know everything. We know the direction of travel, it’s like a sort of expedition. We know now the compass point and where we should be going, but we don’t have it all and we have to build it and we have to build it in practice. So I hope that your trustees will be sufficiently brave and courageous.

RG: So this could be like the subject of another podcast, but this is why I think I probably do disagree with you a little bit, because I completely agree with experimentation, we should be doing loads of experiments, but…

HC: But not the 50k experiments, not the 50k experiments. Experiments rooted in the system that have a chance to grow and tackle that system.

RG: Well, I think we should do experiments at all sorts of levels, you know, lots of quick prototypes, but then more mature pilots, but critically at some point I think you have to do rigorous evaluation with, you know, randomised control trials…

HC: Me too, otherwise you can’t learn. Well…

RG: But that’s what…

HC: Let’s have a podcast on randomised control trials, I’d like you to read Robert Chambers’ book on this, which looks all over the world at some of the challenges of how it pushes work in a certain direction, and let’s do another podcast on that. But please don’t say I don’t believe in evaluation because what I’m most interested in is learning and if we don’t have evaluation we can’t learn and we’ve got to… You know, it’s not like we’re going to design another sort of static 1950s frozen moment and we’ll have got there, we’re going to have to continue to evolve and innovate and that’s why this work’s so exciting and important.

RG: Yeah, I mean I think the reason I do cling quite hard to rigorous experimentation, whether it’s RCTs or other methods, is that I think there’s just so many examples where we’ve thought social solutions are really valuable. So think of microcredit where Muhammad Yunus won the Nobel Prize, and then years of rigorous evaluations have now shown that it doesn’t actually make a big difference to reducing poverty. Or community-based reconstruction and development where lots and lots of evaluations have now shown that involving people in governance hasn’t actually had the impact on trust and improved governance that we hoped and thought it might have. So I think it’s important to just check our intuition and professional insights, because we know that professionals are often wrong and their insights are often wrong, and to check that, it’s a really good challenge to subject ourselves to very rigorous evaluation methods. But I think we would probably have to have like a whole hour to discuss rigorous evaluation methods, but I do think it’s quite important.

HC: Yeah, but Ravi, can I just say that I don’t want you, there’s a sort of implication in what you’re saying that my work is not rigorous, which I really, as you yourself said, you know, there’ve been randomised control trials you can look in the Nesta files for. What I hope you would consider would be the very rigorous evaluation you conducted on my work. So I think rigour is really important, but as you also say, perspectives are really important, who considers that something’s working or not working also means that we have to absolutely expand who is around the table and who is having these conversations and then we need kind of rigour within that. So I don’t disagree but I think perhaps where you’re looking for the rigour might not be quite the right place.

RG: So, without going more into RCT land, I want to end actually with another source of inspiration, actually a source of mutual inspiration, because you dedicate your book to the late Robin Murray, who was a real inspiration to me too very early on in my career. I particularly remember hanging out with Robin, actually Geoff Mulgan as well, for several days following people round while they put away rubbish, and following the binmen round, and he really just taught me the importance of moving from the micro and really understanding what happens in great detail, but then also thinking very macro. Whereas often the policy world was somewhere in between and they never got micro enough or macro. And I just wondered about, you know, your own involvement with Robin and the inspiration he gave you. Particularly for the work because actually reading the book it really reminded me actually a lot of Robin’s energy and humanity.

HC: Oh, that’s such a nice thing to say, Ravi, thank you. I mean Robin obviously sadly died too young and it would have been his eightieth birthday a couple of weeks ago, and there is now something called the Robin Murray Living Library online, you can google it, everybody listening can google it, and all of Robin’s work and talks and papers and this very moving sort of photo essay of his life is there and I think it’s an incredible resource to all of us. Robin taught me, I met Robin when I did my Masters degree at Sussex and then later Robin covered my maternity leave when I worked at the Design Council, which is also kind of complete- only Robin, you know, my teacher and guru and sort of in a way father figure would come along and say, Hilary, I’ll cover your maternity leave. It was a complete inversion and I think says everything about how amazing he was. But I think for me, I mean there’s so many things. You know, I still sort of, when I’m tackling something I think, oh what would Robin say. But for me what is really important is that when I met Robin he understood that the practical work I do, you know, the fact that I had been living in this barrio was just as important and on the same level as the thoughts I had about Foucault. And I think that that’s, you know, I mean not to get back into our rigour conversation, but that’s what’s so important, is that there’s still this kind of enormous divide in our minds, in our sort of culture here in this country about the doers, who are kind of somewhere down there, and then the thinkers, the policymakers who are some sort of elite. And only when we can really, really begin to undo those boundaries and think about all that work together I think will we really move forward and Robin just understood that, practised it, lived it in such an inspirational way.

RG: Absolutely. Hilary Cottam, thank you so much for being on The Mission.

HC: Ravi, thank you so much for having me, it’s lovely to talk to you.

[ends]