In the first part of this blog series, I argued for the need to shift from a Government centric approach to democracy towards a citizen centred one. In the second part I went on to make the case for re-interpreting social change within the context of the politics of small things. Challenging the prevailing view that social, environmental, economic and political change happens with a big bang, instead in line with Jeffery C. Goldfarb, I suggested that change emerges through a web of seemingly disconnected whispers, which in fact are imperceptibly connected in countless complex ways, and that it is these whispers that are the enactment of democracy.

As previously discussed in this blog series, connections, networks, associations, and social movements — that actively include those who are at the edge of their networks and endure over time — are decidedly different in purpose and function to hierarchal systems in how they distribute power and bring about change. 

So in a topsy-turvy world like ours where institutions dominate over networks, how can we possibly enact a citizen-centred democracy? Well, to start we need to become much clearer about the tools for social change that are at our disposal, and what it is these tools can and can not do. To paraphrase Ivan Illich, all progress is contingent on understanding limits.

Curiously across the Right/Left political spectrum there are two points of agreement, both of which constitute fundamental bottle-necks for the growth of citizen-centred democracy:

1. The Right and Left share the belief that a good life is primarily contingent on individuals receiving the right amount of services. They simply disagree on the amount, who should deliver, and who should pick up the tab.
2. The Right and the Left are as one in the belief that poor people can not self determine their own futures. They simply disagree on the reason why and what corrective/palliative interventions are required to improve matters. One considers poverty to be the consequence of laziness while the other thinks it’s the failure to effectively rescue vulnerable/needy people.

So when it comes to the provision of services, programmes and interventions, there is utter unanimity across the House, so to speak. After all who would dare to argue against the equation that more professionally run, better services-as long as they are run cost effectively- equals a better more just society for all? To make such an argument would be tantamount to heresy, and would certainly earn you the ire of the liberal left, who would cast you as a neo-liberal. Even the Right would raise an eyebrow wondering whether you were an anarchist, or some other such odd creature. 

Notwithstanding, the ubiquitous assumption that services can unilaterally make for better lives is scientifically flawed, for reasons clearly delineated here.

In Regenerating Community: The Recovery of a Space for Citizens, John McKnight recounts the early efforts of the Institute for Policy Research to understand how urban Communities get healthier, and better more generally. They came to understand  that starting with a focus on institutional reform was unscientific, since the determinants of health are primarily social not institutional. He recounts in the cited text the moment of insight when the faculty of the Institute for Policy Research realised they had been caught in the “Institutional Assumption”. They were first challenged around this assumption by Dr. Mendelsohn, whom I’ve written about previously here.

“He joined our seminar and quickly learned of our commitment to health through institutional reform of medical systems and hospitals. He reacted with amazement at our institutional focus and said it was unscientific. The great preponderance of the scientific evidence, he explained, indicated that the critical determinants of health were not medical systems or access to them. Therefore, he said, our primary focus on medical system reform was a misguided effort if we were concerned about the health of neighborhood residents. Indeed, he said, we were caught in the “institutional assumption” — the idea that health was produced by hospitals, doctors, and medical systems.

We quickly checked the epidemiological literature and found near unanimity among health researchers supporting Dr. Mendelsohn’s claim. It was clear from this research that the four primary determinants of health were individual behavior, social relationships, the physical environment, and economic status. Access to medical systems was not even in the scientific list of primary health determinants. Nor did medical systems have much potential to affect basic health determinants. So we would have to do our analyses and research outside of medical systems if we were to join in serious efforts to change individual behavior, social relationships, and the physical and economic environments that determined health.

This faculty experience led some of us to adopt a new intellectual focus, and that group became the Community Studies Program. We agreed that we should not begin with the “institutional assumption” that held that hospitals produced health, schools produced wisdom, legal systems created justice, social service systems produced social wellbeing, etc. Instead, we decided to initially focus on the positive conditions of a good life: health, wisdom, justice, community, knowledge, and economic wellbeing. We decided to examine the scientific evidence regarding the critical determinants of each of these conditions.

Once we began this new exploration of the determinants of wellbeing, we found that the health example was a “generalizable” model. There was clear evidence that school is not the primary source of wisdom or knowledge; social service systems are not major factors in community social wellbeing; and clearly, criminal justice systems and lawyers are not the primary determinants of safety or justice. In each area, the evidence pointed us in other directions as we focused on the basic determinants of community wellbeing.

Our inquiry then began anew, and we gathered evidence regarding the primary determinants of well-being in urban neighborhoods.”

This is not an ideological stance, it’s a scientific one. Attempting to address health, social care and so-forth within the grasp of the “institutional assumption” is doomed to have limited to no effect on the things that primarily determine better outcomes in people’s lives, such as income, choice, control and community connections. Institutional reform therefore, will only ensure that ‘the institution’ does a better job of providing services and programmes, and framing policies and legislation that governs these outputs. Since the function of institutions is limited to the production of standardised goods and services. Institutions do not care, people do, and care and human connection is the root solution to most of our health and social care challenges.

Yet the notion that institutions can unilaterally provide/produce care, wisdom, justice, health and wellbeing is all pervasive, in academia, policymaking, at practitioner level and indeed among citizens in general. This notion is the net result of a democracy that is government or technocractical centred. In this paradigm, democracy is therefore defined in terms of consumer rights, not active citizenship. Sadly the right to vote, the right to a service and so on, while centrally important, are hollow victories on their own. In a democracy as well as having consumer rights we also require the rights of citizenship to sit alongside our rights to services and ameliorative interventions. The essential freedom at the heart of all these rights is the right of a citizen to be a producer of the future and to participate in all aspects of civic and commercial life. A consumer casts a vote as an act of delegating their civic work to another. A citizen exercises their democratic franchise so that institutional functions can be created to support citizen-led invention and also to create protections for those whose gifts would be overlooked or oppressed. They vote for a life of free expression, and free association for all. Services are in the mix, but they are not the primary goal, rather they are there in reserve when needed. The primary goals of citizenship after security are income, choice, inclusion and community. And all of these must be grounded in principles of social justice.

In a citizen-centred democracy there are two tools available with which to create change. One is civic inventiveness, the other is institutional capacity. Both have their place, and therefore, their limitations. The genuine radical never allows the mis-guided assumptions of their chosen ideologies to blind them from the root of any given problem. Hence in their hunt for hope and deeper democracy they don’t settle simply for the reform of institutional systems. Instead they seek the power to redefine institutional functions and the relocation of authority from institutional systems to citizens and their associations. Why? Because they understand that at the heart of the democratic challenge is the reduction of institutionalisation in favour of increasing interdependency in community life.

In a government centric democracy we can only ever hope to secure the power to co-design policies, services, and programmes, and even then at best we can only aspire to be satisfied consumers. In this version of democracy when people have insufficuent income, choice, control and community, they become service users. In contrast, within a citizen-centred democracy which is not defacto caught in the grasp of the “institutional assumption”, the primary pursuit is not consumer satisfaction, though that is an important goal. It is a dignified income and that personal autonomy strengthened by collective power, to be the primary producers of health, wellbeing, safety, justice, and wisdom necessary to ensure a good life for all and the planet. Democracy then is the place where citizenship prevails.

All of the above describes the molecular structure of citizen centred democracy and offers a contrast with the molecular nature of the government centric versions which are currently universally supported by the establishment. What it does not do is articulate the atomic elements of the citizen-centred version. So lets drill down yet further: what are the atomic elements of a deeper version of democracy?

Well, if the evidence tells us that the primary determinants of wellbeing, justice, prosperity and wisdom are primarily contingent on our community assets and not our consumer-based capacities to access service, then the logical place to start is in the networked world, not the institutional one.

One of the places that offers significant untapped potential for interdependent connections that are of consequence in the areas of health, wellbeing, justice, prosperity and wisdom, are places where people can associate close to their own doorsteps. Not just interpersonally but also associationally; not just based on single item issues, but around a diversity of concerns and possibilities. Not just around affinity or age, but across the life course and across a wide spectrum of political and local opinion. One of the places we find all those ingredients both nascent and active is in communities of place, what are often described as neighbourhoods.

We rarely see the power of place and rarer still do we get the opportunity to compare that power with the competency of institutions to address social justice issues. But one example where the evidence of what can happen when people collectively take action to include those who are traditionally marginalised, is to be found in Nora Groce’s study of Martha’s Vineyard, ‘Everyone Here Spoke Sign Language: Hereditary Deafness on Martha’s Vineyard’.

I have previously discussed this example in detail here: Fantasy Island: Is Disability Just a construct? Suffice to say, by comparing her findings to the experiences of deaf people across the USA, Groce demonstrated that deafness is not a disability but a different way of communicating. On Martha’s Vineyard deaf people lived their lives just as easily and as fully as everyone else in town as a consequence of the fact that for an extended period of time everybody on the island spoke sign language. They were defined, neither as people with disabilities, nor as disabled people, but as fellow citizens. Her work introduced an empirical case study to a discussion that had previously been mired in ideological rhetoric and established that disability is primarily “defined by the community in which it appears,” (see p. 112).

Across all major health and wellbeing indicators, deaf people did as well or better than their hearing neighbours on the Island. The findings of the study also demonstrate the stark contrast in health and wellbeing outcomes for deaf people across mainland America and those resident on Martha’s Vineyard. Anthropological accounts are replete with evidence of the health and wellbeing capacities of indigenous communities.

Were these folks neo-liberals? Were they letting agencies off the hook for the provision of services to deaf people? Or did they understand that part of their function in life was to foster a culture of inclusive community?

Beyond Globalism and massification, the absence of a coherent political narrative that transcends partisanship and places citizens at the centre of democracy is the single biggest threat to our futures and the planet. It is clear following what happened in Greece last week, that political and intellectual elites can not or will not (you decide) do this for us. We must therefore reflect on how we can mobilise the base at grassroots level. How we can start a positive, constructive whisper campaign that spreads the audacious message that in a democracy citizens are at the centre as the primary inventors and producers of the future. While we may consume services in a democracy as distinct from a market place, we own the shop. We are the golfers, politicians and those paid to serve us are the caddies. That the opposite is currently the case, is not a result of the Right/Left schism. It is the consequence of an ever growing schism between ingenious people and the Governments that are elected to serve them. Elitism and technocracy have all too often replaced civic professionalism and servanthood. It is a stain on the democratic ideal for which both ideologies must be equally held to account.

Communities are all at once both profoundly resilient and fragile. When the agencies that are meant to serve them pull out and refuse to fulfil their brief they do untold harm, but equally when they provide top down bureaucratic services that diminish or demean community capacity they do as much if not more harm. Sometimes helping hurts. The role of government and its agents, indeed the role of all helping agencies, is one of service, not to be confused with service provision. Being of service in a democracy involves supporting community driven invention, not replacing it.

This is why we must halt the obsessive institutional drive to define people and communities by their needs and deficits. The truth is the institutions are not actually scouting out people needs; they are searching for people’s need for their services. Hence they are confusing human needs with their service categories. Typically in my experience when people have sufficient income, choice, control and community connections they do not seek out public sector or third sector services. They shop elsewhere as Judith Snow’s life evidences in abundance. This is not an argument for privatisation, since Judith Snow didn’t primarily seek services in the private sector either. She wanted a life, not a service. Therefore we need to nurture the development of public sector and third sector capacities to support the pursuit of a good life. Of course, this would include services; but would also introduce a new feature to public service, which is community building.

Recently I went for a walk with a number of what I refer to as civic professionals, that is to say paid people who have figured out how to support citizen led invention. We were walking on the Bath Road in Cheltenham. Some of us broke off and went onto Suffolk Road, where we discovered a Militaria shop. Drawn in by the elaborate managorie of military antiques in the shop front window, we soon struck up a conversation with the owner. He told us that most of his trade was done online; he filled us in a little on what he had on display, and then our conversation took an interesting turn. When we told him about what we did, he shared with us that he hosts a group of retired military men, who meet each other in his shop once a week to reminisce and provide each other with mutual support. Its a completely informal get together but it is nonetheless of profound consequence to these men.

Its a simple enough example, but emblematic of what does not appear on our current map of health and social care producing assets. This shopkeepers’ health producing capacity is invisible to most policy makers, practitioners and citizens. Instead, our map sees only the label over his shop and the labels hanging over these men’s heads. When we do not see the relevance of what this militaria shop has to offer to health and wellbeing, we offer these men a service or a programme. The truth is we can never know what these men need until we first know what their community has.

This is why is it so critical when we enter communities as outsiders; we should do so by invitation and without an agenda. As a “helper”, when you enter a community with a defined development agenda like “Health”, then your methodology clearly is not citizen driven or asset-based. However when you enter a community with a commitment to support local residents to make the invisible visible you will discover a significant untapped reservoir of human and associational potential, just waiting to be identified, connected and mobilised by the residents of that place. This landscape of associational life is not very well understood at the moment.

Hence I want to finish with a pictorial representation of what the typology of associational life looks like (click on image for high resolution):

When developed by residents, these portraitures depict in graphic detail the atomic elements of molecular democracy. As well as many, though not all, of the ingredients needed to grow a good (healthy, well, prosperous, safe and wise) life. This picture also offers local residents a route map that will guide their journey from being clients to being citizens.

Next week is the final blog of this series and I will be looking in more detail at how we can grow inclusive power at neighbourhood level in a way that proliferates beyond the neighbourhood level. I will also be exploring what this looks like on Monday morning. In other words, what this looks like in practice.

Read the Other Instalments in this Series:

Part 1
Part 2
Part 4

This blog was originally posted on the Nurture Development website, and appears here with permission.