LESSONS FROM CHELTENHAM (my personal takeaways):


  • Worldwide, human services systems are not designed from the standpoint of the ‘end-user’. Experts by experience repeatedly
    told us of being powerless in their interactions with systems and often patronised by insincerity.


  • Worldwide, human services systems are not designed to nurture and support strong citizens, families and communities –
    policy-makers seem to be ignorant about and dismissive of the centrality of the core/relational economy.


  • Worldwide, the expansion of markets and market values into the organisation of how we care for each other throughout our
    lives has proved cancerous.


  • Worldwide, we seem to have lost the ability to think ‘societally’. “Consume our stuff” instead of “Let’s work together to sort this
    out” dominates governmental culture.


  • Worldwide, the cost of managing transactions in insidiously collapsing arrangements grows and erodes any potential for more
    societal or communitarian initiatives. In the UK locality-based, relational, community social work has been sacrificed at the
    altar of ‘market management’ and ‘fairness’ in the process of rationing that is implicit to the system.


  • Worldwide, the ‘organ grinders’ are usually good, well-intentioned people who, in general, act in accordance with the cultural
    norms of their place and time. The prevailing environment is one where citizens are redefined as consumers and where the
    state’s role is to meet its customers’ demands for goods and services – an impossible circle to square.


  • Worldwide, the usual governmental reaction to this dilemma is authoritarian. In Surviving the Future (2016) (1)Fleming opines
    that, “perversely”, when a system is collapsing, “the conventional responses to this phase seem to be devoted to the cause of
    making the system, in its hour of need, even less resilient… solutions are sought in standardisation and efficiency
    improvements, in increasingly centralised command and control, and in tighter insistence on process, rules and procedures –
    that is, stamping out any new vision, experimentation and self- reliance… the solution is seen as even larger scale, greater
    rigidity, and further complication – a classic case of the amplifying feedback of a complicated system in trouble”. This is the
    increasingly top-down regulated, command and control culture that is presently concreted into the heads of our rulers.

  • An Alternative Narrative, would encourage good, well-intentioned leaders to take heed of Intervention Theory(2) and spend
    time genuinely studying the impact of their policies bottom-up and normatively so as to understand the current operating
    principles prevalent in the system. From this, informed decisions based on knowledge can be made by leaders regarding how
    to lead the creation of a transformed system. NB. Studying is not receiving reports and recommendations from others – no
    matter how celebrated! It involves live and tangible experiences.


  • An Alternative Narrative, encourages our leaders to set aside their Left v Right worldview and embrace the Individualism visa
    vie Communitarian axis and a more ethical and societal (as against economic and materialist) perspective. I would assert that it
    behoves our leaders to consider what constitutes a good life when exercising what power they have. It’s arguable that current
    mindsets award little value and real humanity to those of us who are ‘economically inactive’ - neither meaningful units of
    production nor enthusiastic consumers. Surely a good life encompasses far more than an economic role for all of us and the
    state should fully nurture that humanity?


  • An Alternative Narrative, starts by putting citizens, families and communities at the heart of its vision of a good society where
    citizens pursue their best lives. It recognises the gifts and assets that reside in the core economy or relational sphere. It
    understands that loving and reciprocal relationships and belonging are fundament psychological needs that must be served if
    real care is to be experienced by the cared for person. It embraces the goal of, wherever feasible, helping people, in the context
    of their familial and social networks, help themselves and describe their criteria for a good outcome.


  • As a consequence, the foundation of an Alternative Narrative is a commitment to a local, devolved, and person-centred care
    system that is democratically designed and developed as locally as possible to nurture strong and resourceful citizens, families
    and communities; and promote inclusion, interdependence, and citizenship. Services designed and provided within this
    system will be supplementary and complementary, serving needs that require specific expertise and/or person-power where
    appropriate in partnership with kith and kin.


  • The role of national governments in the circumstances set out in this Alternative Narrative is to specify the essential purposes
    of – not methods employed by - care services in the context set a out above and then to be very attentive to ensuring that
    national system conditions are incrementally put in place to ensure that local arrangements thrive. This may involve exploring
    scope for initiatives like Universal Basic Income to be introduced in order to free citizens to play a full part in their family and
    community, revisiting self-direction and personal budgets as enabling tools, and taking obstructive competition rules out of
    the human services arena.


  • In short, this Alternative Narrative says TRUST THE PEOPLE, help people help themselves, for professionals to engage with
    Family and Friends as equal partners, to focus on purpose not pre-ordained menus of pre-commissioned ‘solutions’, and to
    attend to value (getting the job done) not cost. It stands to reason that costs burgeon when we repeatedly don’t get it right.
    Folk who measure demand by counting referrals and transactions will never understand this.


  • My Alternative Narrative also shouts that we need to reinvent professionals with relational and community knowledge and
    skills and trust these ‘collegiate’ Professionals to assist citizens and those who love them to pursue their best lives.


These are my reflections following our stimulating time in Cheltenham. A ‘Communique’ capturing the collective wisdom of our 40
or so international guests is presently being finalised by a small team of volunteer ‘rapporteurs’ in consultation with all
participants. We’ll be publishing the Communique as soon as it’s ready. No doubt it will be more focused on practice matters than
these thoughts.


After more than half a century’s professional involvement in human services I’m convinced that, given helpful system conditions,
there’s little we don’t know about best practice. Our problem resides in the fact that the imposition of market practices and values,
and the commodification of services have imposed system conditions that obviate the possibility of best practice. Further to this,
our fundamental dilemma resides in the fact that our political and ‘Whitehall’ people are deaf and blind to societal solutions. There
are many of us happy to help them study and experience alternatives if only they would ask!

Unlocking a New Vision for Care:
Lessons from Cheltenham 2024

By Bob Rhodes

The LivesthroughFriends Cheltenham Summer Institute in September 2024 brought together experts from
around the globe to discuss the shortcomings of current care systems and explore alternative approaches.
The goal was to promote effective practices and inspire a new international narrative for change.

(a word cloud comprising some of the practitioners and thinkers who have influenced us – many of whom
have been widely celebrated BUT eventually ignored by those who design human services systems in most
jurisdictions)

The Planning of Change (1985), Warren G. Bennis, Kenneth D. Benne, Robert Chin.

David Fleming, Surviving the Future: Culture, Carnival and Capital in the Aftermath of the Market Economy 2016

-Bob Rhodes October 2024.