Some Reflections on Inclusive Growth and Colliding Paradigms

Yesterday over 100 people gathered in Horizon at Brewery Wharf on the paved over flood plain of the River Aire in Leeds.  While the warm air of Storm Ciara ripped at the cladding and dumped its increased burden of rain onto the hills and valleys it transpired that our keynote speaker was unable to make the journey from the south coast due to widespread transport failures. 

Brewery Wharf itself was looking tired and grey, with apologetic sandbags burst open and significant building works underway. I had cycled down with the wind and rain ripping at me. I’d been abused by a driver who narrowly avoided ‘left hooking’ me on Regents St as he was unable to progress, stranded across the bike lane. His anger transmuted into an order for me to go forth and multiply. When I arrived I struggled to find anywhere to lock my bike. Leeds.

After the formalities of the welcome Tom Riordan, CEO of the council, spoke to us and answered questions for the best part of an hour to fill the gap left by our stranded speaker. I thought the almost biblical conditions might provide the perfect space for a city to pause, reflect and ponder whether a course correction might be required.

Flood warnings
Flood warnings in Leeds as we met…

Tom started off sharing his expectation that about 15 people would show up, given the weather and the warnings.  But loads had turned up and how very ‘Leeds’ that was.  To not let ‘a little weather’ stop us. To carry on regardless.  This might turn out to be our Achilles’ Heel.

He acknowledged the tremendous work of the council teams and volunteers who had worked since 4am on Sunday to avert a flooding disaster in the city. He thanked the engineers of the moveable dams first used in Portugal and now here in Leeds to manage the unprecedented river flows. He acknowledged the floods further up the valley and the damage and suffering that had been caused. But WE had escaped with a close shave thanks to investment in technology.

Can we outpace climate change?

I wondered, as the climate continues to warm and the atmosphere holds even greater quantities of water ushered in on even higher wind speeds, for how much longer our flood defences could outrun the climate. 20 miles up the valley and 4 significant flood events already this century in the city (remember those assurances about once in a hundred years?) hinted at a possible answer.

I reflected on the advice of one of the worlds leading systems thinkers, Gregory Bateson, to be “alert to the tendency to let technological possibility or economic indicators replace reflection; for the effort to maximise a single variable, like profit, rather than optimising a complex set of variables.”

Perhaps this was a space for reflection and alertness?

Tom described the great successes of Leeds, the city and its economy, and the councils’ progress. Homelessness is lower than our neighbours. We are going to double the size of the city centre. We are going to develop strategic partnerships with developers and business. We are going to take the idea of ‘anchor institutions’ pioneered in the voluntary, civic and social enterprise sector and bring it to the world of the large employers who could do more to recruit and develop local talent. He spoke of new roles being pioneered at the hospital combining a health care assistant with a social prescriber (an opportunity for a new TLA surely) to provide career opportunities for local people in the ever expanding illness business. 

I reflected on how much of this burden of illness was significantly contributed to by poverty, debt, anxiety, addiction, poor air quality, poor housing, homelessness and loneliness, and how much of that was contributed to by ‘strategic partners’ in the city like William Hill, Sky, and Channel 4 with adverts for consumption and gambling inclusively beamed into nearly every front-room and smart phone in the city.

The price of prosperity is rarely paid by the prosperous.

We Can’t Stop Capitalism. Can We?

Tom reminded us that ‘we can’t stop capitalism’. I’ve heard him talk before about the importance of ‘going with the grain’.

And I’m not sure that is what any of us wanted. The end of capitalism. Not overnight anyway. Some of us just wanted, as good credit card carrying capitalists, to recognise those that were excluded from growth, damaged by it, discriminated against and left behind by it. To consider how we might use it to care for the planet rather than to kill it. And to reflect on what we might be able to do about it. How we might change things. For the better.

To reflect on the way that growth was a problem as well as an opportunity. It really IS easier to imagine the end of humanity than the end of capitalism.

Tom then talked about the vibrant ‘third’ sector. It is often described as vibrant in Leeds. And it does have some incredible people who have been working for inclusion and equality for decades, using hard won funding cocktails of heavily scrutinised, usually short term, contracts and philanthropy. When money is on the table ‘vibrant’ is a good persona to adopt.

I’ve known many of Leeds ‘third sector’ leaders for decades and I know that for some, accompanying their ‘vibrancy’ is anger, frustration and exhaustion.

Tom was brilliant. Engaging, witty, informed. But I’m not sure we grasped the nettle of who was left out of the economic growth and why. No mention of ‘discrimination’. Or whether economic growth was as much part of the problem as the solution. The message seemed to be that we need to double down on our efforts.

Economist Serge Latouche has developed the concept of de-growth as a way of averting the crisis that may (or may not) be looming. After decades of speculative and financial euphoria, punctuated by the odd crash and policy of austerity, the Leeds economy is ‘doing well’. But many of its people aren’t because of displacement, the retreat of the welfare state, the increased precarity of the gig economy and under-employment.

What if we put human wellbeing before, or at least alongside profits? What if we tried to optimise many variables, instead of focussing on one?

The Wellbeing Economic Alliance seem to be working on this and are well worth a look.

Perhaps there is an opportunity to develop de-growth initiatives in a spirit of solidarity, working together to create a new era that aims for a calm, responsible decrease in consumption fostered by a love of all species and our planet? Rather than putting humans, especially those with ‘potential’ at the centre of things, what about if we saw ourselves as just a small part of a much larger and complex ecosystem? What if we were able to change the paradigm? But such radical thinking was not, apparently, on the agenda.

After a well resourced break it was workshop sessions.

I attended one on ‘Culture and Place’ and one on ‘Thriving Communities’. We had just over an hour for each workshop and the majority of the time was spent with speakers addressing the room with very little opportunity to really get into the complex issues in table discussions.

The variety of different perspectives on the same issue were leading to conflict especially where third sector knowledge of communities and private sector enthusiasm to help were at odds. At one point I could not hide my frustration when a session that should have been exploring our role, and what Leeds could do to help, collapsed into a conversation about how two big businesses with mixed reputations in the city might effectively provide enterprise training as part of their CSR work, because “it is better than painting fences”. The long history and experience of doing enterprise development work in Leeds counted for little in the face of four sessions of training that ‘worked’. Enthusiasm from the private sector unless melded with the experience of the third and civic sector and local community developers really IS likely to do more harm than good. One of our table explained that community and business were miles apart. I wondered if they had ever visited Harehills where community and business are intertwined both spatially and through familial ties.

It was a strange moment for me. I was starting to ‘other’ my colleagues from business, but without the time or the safe pace to really have the conversation I felt left with little alternative. And even though I know this is a dangerous and destructive dynamic I felt myself falling into it.

It wasn’t about personalities. It was about paradigms. Some were in the paradigm of ‘big business as a force for good full of good people that care‘. Others were in a paradigm that said ‘beware big business, knowingly or not’ it damages people and planet and shows little real intention or desire in stopping’. Some were in the paradigm that said ‘growth is sustainable’. Others in a paradigm that said ‘growth is not sustainable’.

Some were in a paradigm where they had answers. Others were in a paradigm full of curiosity and questions. Some were in a paradigm of making nips and tucks to the existing way. Building better dams and higher walls. Others were in a paradigm that that sees the need for a fundamental change in what we value.

Would we be able to hold both paradigms respectfully? To learn from each other? To support each other to move forward with love and kindness? Not in the few minutes in which we had for our paradigms to collide. No.

I have been working on the idea of paradigms and how they shift for a while now. I have written a little about it here. And run workshops to help leaders explore their role in developing and shifting paradigms.

Much was made of Leeds diversity as a strength. But unless we find the time for the diverse perspectives and different paradigms to listen to each other with respect and care the diversity is more likely to lead to chaos than creativity. To less inclusion rather than more.

In the plenary session one of the speakers quoted a piece of radical engagement work in Copenhagen that took place after riots had rocked the city. As a city and a region we have a history with riots and I hope that such unrest is not necessary to trigger a genuinely creative and transformational response to our times.

Im not a great one for celebrity leadership. But when I got home Joaquin Cortez gave me hope…

Run to the rescue with love and peace will follow…

“We fear the idea of personal change, because we think we need to sacrifice something; to give something up. But human beings at our best are so creative and inventive, and we can create, develop and implement systems of change that are beneficial to all sentient beings and the environment.”

Joaquin Phoenix – Oscar Acceptance Speech 2020

We need a space for thinking and imagining where the realists and pragmatists can take a back seat while the idealists and the imagineers can develop ideas about how things might be. To build a consensus and commitment to move towards a very different but eminently possible future.

YOU are the problem we have been looking for…

Mike Chitty Realise Development

This is the conclusion of many workshops, conferences and articles designed to help us to deepen our understanding, raise our awareness and develop more effective anti-racist practices.

The problem is what Professor Kehinde Andrews calls ‘The Psychosis of Whiteness‘. Whiteness as a historical process that perhaps can be unpicked, understood and transformed.

But Professor Andrews also says that ‘whiteness is not just for whites’.

It is not just about the skin tones of individuals, but about historical processes of othering, domination and exploitation which are still alive and well, perhaps in more covert and subtle ways that are no less powerful. The first recorded slaves were the Slavs.

The problem is perhaps the human tendency to dominate, exploit and dehumanise in search of safety, security and power. To secure power over. Domination and exploitation are not restricted to members of our own species. We will dominate and exploit anything if it meets our needs. Meetings, conferences, other species, ecosystems, planets, space… This tendency towards violence is in us. Part of our biology.

Part of our biology. Part of our evolutionary past. And our evolutionary future depends on us transcending it, quickly.

Recognising that domination and exploitation cannot be sustained. That our facility with violence has to be replaced with our facility to love, to care to nurture.

And this facility to love has to recognise the ripples, the tsunamis, from the past that still rage through our modern societies, organisations and our psyches, leading to exclusion and discrimination, allowing us to find ways to listen deeply and change how we behave. Change how we are. To be different. To learn how we develop power with and power to…create a better future.

And for me this is at the root of our work with the NHS Leadership Academy’s Reciprocal Mentoring for Inclusion Programme, where we bring together members of the ‘in power’ group, senior leaders, ‘bosses’ with a broad coalition of people ‘staff’ who feel less powerful, left behind, through race, gender, sexuality, age, disability or any other characteristic that to them feels relevant. Even the language of ‘bosses’ and ‘staff’ are deeply rooted in models of power, domination and exploitation.

Our starting point with Reciprocal Mentoring is not to induce the feeling that ‘You are the problem’. More that ‘We have a problem’ and the only way to explore it is to learn to talk together and change and to transcend the domination instinct. That by changing the way we relate to each other in the present, with a shared and growing awareness of history and human nature, we may be able to create a better, more loving and inclusive future that realises the ambition of the NHS Constitution that Everyone Counts.

We maximise our resources for the benefit of the whole community, and make sure nobody is excluded, discriminated against or left behind. We accept that some people need more help, that difficult decisions have to be taken – and that when we waste resources we waste opportunities for others.

NHS Constitution

Everyone counts…but some might count more than others?

We maximise our resources for the benefit of the whole community, and make sure nobody is excluded, discriminated against or left behind. We accept that some people need more help, that difficult decisions have to be taken – and that when we waste resources we waste opportunities for others.

NHS Constitution – Values
Mike Chitty Realise Development

I think the NHS Constitution is a wonderful document. Beautifully written, it speaks powerfully to many of us about the NHS that we want to use and work in.

One of my frustrations in working with the NHS is the infrequency with which we consult the values explicitly to help us with decision making. The values are beautiful, but in my experience, appear to be used infrequently as a management and leadership tool.

There are 7 values in all and they set an incredibly high bar. Take this one – Everyone Counts. It is the value that to my mind speaks most explicitly about the NHS ambition with respect to diversity, inclusion and equality.

I think that, in practice, we often stop reading after the first clause. We maximise our resources for the benefit of the whole community. We do our best with limited resources to provide the greatest health gains for the greatest number of people that we can. We work on ‘population health’ But in practice this means that the second clause of the value often gets neglected – We… make sure nobody is excluded, discriminated against or left behind.

Because, in practice, in terms of health outcomes we have been ‘leaving behind’ the same groups for decades. Whether this is through processes of exclusion or discrimination, or just lack of clinical knowledge I am not certain. I suspect that many factors, mostly found in wider society, play a part.

But until our health and care strategies start with a real commitment to help those that have been systematically ‘left behind’ to catch up as quickly as possible we will have widening health inequalities.

So let us re-visit the third clause in the value We accept that some people need more help, that difficult decisions have to be taken. When we take these difficult decisions, what will benefit the ‘whole community’? A focus on creating as much health gain as we can, for as many as we can, for a fixed cost? Or spending our money in a way that helps those that have been historically and systematically left behind by the system to catch up? How do we find the balance?

Who are we choosing to ‘leave behind’?

This is becoming an increasingly pivotal question for me as I work in primary care networks, integrated care systems and NHS Trusts. And if you care about equality and inclusion then perhaps its need to be a question that you are prepared to ask too.

I am also increasingly striving to increase ‘community engagement‘ not through the usual processes of patient participation groups and so on but by going directly in to communities and engaging them in playful conversation, often with academics, clinicians, commissioners and managers so that their voices can be heard directly and relationships formed that will start to change the system.

I would love to hear what you do, in your practice that helps to raise awareness, interest and action in tackling health inequalities.

Please leave us a comment!