News and Comment

Changing Times with Lord Victor Adebowale

Friday 17 May 2013


Today’s Changing Times interview is with Lord Victor Adebowale, Chief Executive of Turning Point a social enterprise, focused on the issues of mental health, learning disability, substance misuse and employment.

 If you compare today’s society and the society into which you were born: what’s most strikingly different, and what’s most surprisingly similar?

Well I was born in 1962 at a time when racism was pretty much casual and politicians thought it was okay to get elected on a platform that was, to a greater or lesser degree, racist. It pretty much remained that way throughout the 1970s and 80s, when racism was a popular pastime and even created some pretty good television series.

I think one of the things that I’ve noticed now is that there’s more shame around racism, more embarrassment and a greater sense of disgust. That isn’t to say racism is a thing of the past at all, it clearly isn’t, but I think it’s certainly less obvious. I think that multiculturalism is an accepted norm now in a way it just wasn’t before.

What’s similar? I think the class system. Although it is expressed in a more sophisticatedly now, it remains remarkably resilient to change. There are certain rules that money cannot break and as such having money doesn’t necessarily make you of a different class. But being of a certain class gives you access to privileges and opportunities that others are denied, no matter how much money they have. The professions and politics in particular have remained remarkably static.

I think the class system is expressed more subtly today than in the past, but in a way this also makes it more solid. There’s more of a pretence that class discrimination doesn’t exist.

Given difficult choices have to be made, what one public service or source of support do you think we should prioritise most highly, and why?

I think health and social care is most important. You only have to look at the newspaper to see the panic – and it is panic – at the possibility that your kids might catch mumps. 30, 40, 50 years ago diseases like mumps, measles, rubella and croup were all common. And people died. People died of diseases we can now cure. And people didn’t get access to a GP. Nowadays people expect to see a GP, like they expect to go to A&E. 65 years ago you didn’t. If you couldn’t afford it, that was it. That literally killed people’s life chances. So having a universal health and social care system that people can plug into, stay healthy and make the most of their life chances is absolutely vital. Without that I think they would question whether we had a civilised society.

Of course the challenge is for us now is to make changes to the system in line with the changes that are and have taken place in demography life expectancy, expectations, and resource. There’s no doubt that this will be a difficult, but I think it’s important to note that these challenges are partly due to the success of the health and social care system. They are not challenges of failure as many commentators suggest.

After all, it’s a good thing that people are living longer or that people’s expectations have raised. But the system can’t exist in the abstract. The system starts to fail when we have a romantic view of it, which prevents us from making pragmatic decision in light of what we know about expectation, resource, and demography.

If you could choose one person to be the Prime Minister’s adviser, who would that person be, and why?

I would say that whoever it is needs to come form outside the usual suspects and needs to have something that is hardly mentioned these days: wisdom.

So for that reason I would choose Doreen Lawrence. I’m not saying this because of the terrible tragedy that has happened to her, but because of what she did with that tragedy. She used it to gain masses and masses of wisdom. She has changed the way the nation thinks about itself, not just in terms of race, but also it’s relationship with power.

I think one of the things that Prime Ministers need is to be aware of is the human impact of their policies. That’s not because the PM should go to bed in tears every night, but I think power has a tendency to weaken the humanity of the powerful.

The scandal following the murder of Stephen Lawrence was so shocking that it almost transcended the event itself. It led us to ask whether we can actually trust the institution we rely on most to keep us safe.  Doreen’s work created a paradigm shift in how we question our institutions and how we hold them to account. How transparent are they? How open are they? How do they learn? How do they engage with the public?

She rose above the personal tragedy to become a genuinely wise person with the ability to shift public opinion and she did that through sheer tenacity and the refusal to be ignored; qualities which you’d also need as a Prime Ministerial adviser.

Public services rely on voluntary support more than ever: is this to be welcomed?

It always makes me smile when people say we need more volunteering in this country, because actually the country is pretty much run by volunteers. But the problem with volunteering is that it isn’t distributed equally across the country and therefore doesn’t lead to equitable outcomes for all.

This makes for a poor substitute for services to the public and it’s one of the reasons why companies like Tesco don’t use volunteers. People need their services to be reliable and available on an equal basis everywhere. You don’t want to go to Lincoln and be told: “Sorry there’s no social services because people are doing three jobs”.

I think you would get all kinds of unintended consequences with that kind of approach to public services. Apart from anything else, I think it also undermines the very principal of public services.

There are people, not many, but there are people who think that if it’s not run by the private sector it should somehow be run by volunteers. And of course they are forgetting that it’s not that one sector is more important than the other, they both rely on each other. So it’s a “both/and” issue, not an “either/or”.

In the best case scenario, what will public services be like by 2023? What about the worst case scenario?

In the best case scenario you would have bespoke services. That means personalised and driven by the values of transparency, access and outcome, that isn’t the same as a post code lottery, bespoke means individuals and communities get services that meet their particular needs. In fact you wouldn’t really call them public services; they’d be services to the public, because I think people would genuinely question what a public service is.

In this scenario, the idea that a private company can establish itself as having a right to make outrageous profit from public money would be seen as laughable. But that doesn’t mean that a private company should be stopped providing services to the public, as long as the public can see a value.

The inverse care law would also be something that all providers of services would be aware of, and unless they were driving out the inverse care law, they wouldn’t get public support to provide anything.

In the worst case scenario I think you can almost reverse what I’ve just said! It’s almost not worth thinking about, what you would have is the smell, sight, dangers and outcomes of a corrupt and corrupting failed state.

But I think the truth probably lies somewhere closer to the best than the worst of these scenarios. There’s an inherent sense of fairness in the culture of the British people.

Previous Changing Times contributors

Matthew Taylor, Chief Executive of the RSA.

Professor Kate Pickett, epidemiologist and author

Carolyn Downs, Chief Executive of the LGA

Professor Chris Drinkwater, President of the NHS Alliance