Category: Culture Change

Love Society – Part 1 – Prof Bev Skeggs

 

Here in Morecambe Bay, a very eclectic group of us are having some conversations about how we might reimagine life together based on love and kindness towards people and the planet. In April, we were together around the theme ‘Love People’ and in May, this became ‘Love Society’.

 

To help us and catalyse us to really think about the issues involved, we welcomed Professor Bev Skeggs (Class, Self, Culture) and Hilary Cottam (Radical Help). This blog focuses on Bev and the learning she brought. There will be more on Hilary in future posts….

 

 

Bev is quite frankly amazing and is described by many in her field as the leading sociologist in the UK! She has been, until recently, Professor of Sociology at The London School of Economics, where she ran the Atlantic Fellowship Programme with the equally formidable Dr Kate Raworth (Doughnut Economics) and Dr Jason Hickel (The Divide). We are extremely happy that she has now joined the faculty at Lancaster University, thanks to the canny leadership of Prof Imogen Tyler. She opened our time together with an incredible tour through society, what it is, how it functions, how power relationships are held in place, how our judgements affect our relationships and how we create value and values! It is honestly the most helpful, eye-opening and challenging piece of teaching on society that I have ever heard. So, get yourself a cup of tea, sit back and watch this (credit to Andrew Towers and Purple Videos!) – then watch it again and let your thinking be undone and remade by this remarkable woman!

 

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Love People! – Part 2

Continue reading “Love People! – Part 2” →

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Love People! – Part 1

I’m currently in the process of hosting 4 conversations across Morecambe Bay on the following themes: ‘Love People’, ‘Love Society’, ‘Love Economics’ and ‘Love Politics’. We have people from all walks of society coming together to give space to imagine what life might be like if we built together on the foundations of love and kindness.

We decided to start the conversations off by talking about ‘Love People’ – because the reality is that unless we learn to really love people – which is gritty and hard at times, especially when it comes to loving those who are really different to us or even our enemies, we can never infuse society, economics or politics with a love that really brings transformation. Love like this requires deep forgiveness and serious guts! However, even loving those we consider our brothers and sisters can prove nigh on impossible at times and can even involve betrayal – how do we love through that?

We had a really rich day together. This blog has the first two inputs of the day (which helped form much of our conversation together). The next one will also let you in on the wonderful input from Sue Mitchell and others. Obviously – most of the day was left open for creative space and discussion – but I hope that these videos can give you a flavour of what we’re exploring and provoke some good conversations wherever you may be.

 

This first video is the opening, incredible contribution that Jaz Ampaw-Farr made to the whole process. Jaz lives with such amazing bravery, vulnerability and passion. She invites us to consider what it might mean to be 10% braver in how we love people – this is beautiful! Make yourself some time to enjoy!

 

This second video is the panel discussion, with some wonderful friends (Roger Mitchell, Jaz Ampaw-Farr, Siobhan Collingwood, Dave Higham and Mike Winter) followed some reflective questions which Jaz stirred in the room:

 

 

 

 

 

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Wisdom From My Nanna

Last week, I was on the closing plenary panel at The Kings Fund, as we reflected on what we had learned together about ‘PopulationHealth’ across the UK. There were some really excellent contributions throughout the day.

 

Councillor Matthew Brown, leader of Preston City Council, talked powerfully about the new economic models they are using there and the incredible regeneration they are seeing. Councillor Becky Charlwood, spoke about the great work being done across the city of Leeds and how strong relationships enable them to flex around complex legislation. Mayor Andy Burnham spoke with humility and realism about the power of devolution and the challenges they face as a city in Manchester in giving kids a great start in life and ending homelessness. Liz Gaulton, Director of Public Health in Coventry, spoke about how the Marmot principles are radically shaping the future plans of the city in thinking about inequalities and how they face them together. Prof Kate Ardern, from Wigan, talked about how we need to change our relationship with power and work radically differently with our communities. Prof Dominic Harrison from Blackburn brought his wisdom on how we face up to multiple unhealthy risk factors. Perhaps the most important contributions from my perspective were from Carina Crawford-Khan, lead organiser of Citizens UK and Dr Charlotte Augst, CEO of National Voices who asked us to reflect on how “Powerlessness leads to ill health” – that’s a statement worthy of pause and much reflection. Power is the ability to act. Anger without power leads to rage. So, if we don’t radically change our relationship with power, we can never see true population health – rather we have disempowered people who feel angry and unable to be part of the change we need to see.

 

The reality is that all of the things we long to see in society will not happen unless we ourselves are willing to change. In all the uncertainties we face and admidst the brokenness of our political and economic models, how do we stand firm and find a new way through to a way of being together that is socially just for humanity and sustainable for the future? In reflecting on all of this in the final panel, I drew on the wisdom of my Nanna.

 

My Nanna, Joyce, who is 97 years old this year and who still wakes every morning to play Mozart and Chopin on her beloved piano, has always been one of the most important people in my life. In our family, we call her “Yoda”, because she is strong in the force and exceedingly wise! This 5ft tall lady, who taught me to bake, spent hours helping me with my music and can still whip my butt at scrabble and rummikub, is a truly remarkable woman.

 

When I was a boy, we used to talk to each other whilst making ginger biscuits. My Nanna is a deeply spiritual woman and she used to tell me about her favourite bible verses, one of which is from the book of the Prophet Micah, Chapter 6 and verse 8. That verse says – “God has shown you the best way to live – act justly, love mercy and walk humbly with your God”. I think those three statements hold profound and ancient wisdom that we need to draw on in the complexities of what we face together now. What does that actually mean for us in practice, as we try and transform culture, relationships and behaviours? I suppose I think it’s pretty simple.

 

Firstly, as leaders and as people who want to see change, we must act with justice. We must care deeply about issues of injustice in our society and be willing to challenge it whenever we see it. But we must not just care, we must act. We have to be willing to put justice into practice in what we build. We’re beginning to see this, and it’s exciting!

 

Secondly, we must love mercy. I think that means we have to love the principle of mercy and therefore we have to love people with mercy, or as I put it at The Kings Fund, with real kindness. I love what Prof Micheal West says, when he talks about looking at people with kind and fascinated eyes. We did a lot of thinking about the need for a different kind of power. I think we need to unashamedly talk much more about love and the transformative power it holds. MLK said that love on it’s own is anaemic – it certainly can be. Power alone is destructive. But power and love together is a force to be reckoned with! We need this kind of love in the power that we hold to keep mercy at the fore and kindness as our way of being.

 

Thirdly, we need to walk in humility WITH our communities. I replace the word God here, with communities, not because I don’t believe in God (I do), but then Nanna and I used to talk, she would tell me that walking humbly with God means walking humbly with other people – with your community. It is worked out in the practice of every day life and being willing to interact with and be changed by the person you most look down on or despise. Nanna isn’t a fan of people getting too big for their boots. She sticks her tongue out at arrogance and blows raspberries at pride. She’s not into titles or pretensions. As a true elder, she knows humility and walks in it. I have learned so much from her and it has shaped so much of who I am and how I choose to spend my time. We must learn to sit with, be with, learn with and create the future with our communities. We don’t have the right to dream up plans and do them to people. Together with, is the kind of humble, mercy-loving, justice-acting way that we so badly need. Without those under-girding, foundational truths, we will never see true population health. Our guiding principles and undergirding culture will shape what we become together.

 

In a time of so much uncertainty and complexity, we do well to stop and draw on the wisdom of the elders. And so I offer that of my lovely Nanna – in all you do, make sure you act with justice, love with kindness and walk in humility with your community. 

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An Open Letter to NHS Staff – This ‘crisis’ is not your fault – you’re doing a great job!

If you work in the NHS, in any capacity, this letter is for you, no matter what your role.

 

Dear NHS Staff Member,

 

I write this to you as a GP, who cares for many people who work in the NHS and sees the huge stress many of us feel under. I write it as a ‘system leader’ in my role as Director of Population Health and as someone who has been a patient myself, twice in the last 12 months.

 

We are constantly told that the NHS is in crisis (I’ve even written blogs about it myself!), that we’re not meeting targets, that we’re getting things wrong, that we’re struggling to cope under the strain of demand but not being efficient enough and it can feel like what we’re doing isn’t up to the mark. With all the other current surrounding narratives we live with (like Brexit and Climate Change), things can so easily feel overwhelming.

 

So, I just wanted to write and tell you that the NHS is not in a crisis. We’re just underfunded and understaffed and we’re doing the best we can in those circumstances. Demand is growing year on year and we’re dealing with real complexity. We’ve been under the biggest and longest squeeze on our finances in NHS history, for the last 9 years, and the 3.4% uplift we’ve been promised, although welcome, is not enough to keep us running as we are and do the transformational work required of us. We don’t have enough people to deliver the work we’re being asked to do and so it’s no surprise that morale is low and burn-out levels are high. None of that is your fault. You are doing an amazing job. Every day, you turn up to work, in the context of everything else you have going on in your life and you are helping to deliver a truly world-class health service. Good job!

 

Amidst all the rhetoric you hear, the targets you feel under pressure to meet, the constant flow of people through the doors, the blame and complain (and sometimes bullying) culture that can grind you down, the traumas that you deal with every day, the pain that you help people process, the love and compassion that your pour out, the siloes and frustrations with the clumsiness of the system at times and the long hours – of which you work above and beyond most of the time…..know that you are more than your job and you are valuable just for who you are.

 

So, in all the busyness, remember to listen to and look after your own needs and those of your team around you. You can only do what you can do, and you’re doing a great job. Think about Maslow’s hierarchy of needs and how much you are attending to those things.

 

Physiological Needs – are you listening to your body? Are you getting time to have a drink, eat well, stretch, sleep and get to the toilet ok?

Safety – Are you feeling safe in your work? Do you feel protected? Are you worrying all the time about making mistakes? Do you feel it’s ok to make a mistake and be able to talk about it and learn from it, without fearing some awful consequences?

Love and Belonging – Do you feel like you are an important member of your team – that you matter, that you belong, that people around you care about you? Maybe in the humdrum and mayhem of everyday, we forget to tell each other.

Esteem – How is your self-esteem? Do you feel confident in who you are? Are you treated with respect and kindness and treating others with the same – no matter who they may be?

Cognition – Are you in a place where you can think clearly, make rational choices and in an environment which values learning and development?

Aesthetic Needs – Are you taking time to admire the beauty around you and enjoy life? Without this, it’s really hard to keep motivation alive, especially when things are tough and work feels really pressured. Taking time for this changes your perspective on everything else. How is your perspective? Is it in or out of kilter?

Self-Actualisation – Are you able to be spontaneous, making wise and creative, moral choices, problem solving without prejudice whilst accepting the facts in front of you?

Transcendence – This is the place we are aiming for as human beings – that ability to move out of our ego and into the place of gift from which we can love the ‘other’ and even our ‘enemy’ with the kind of transformative substance that changes the world.

 

The truth is, you can’t get to this place of self-actualisation and transcendence if the other areas aren’t looked after – so what needs attention? What are you noticing that needs taking care of? Don’t worry about all the pressures from on high – it’s all part of a system of biopower that needs to measure things to keep control. You – yes you, are valuable and important and the contribution you are making every day is phenomenal. You will certainly make some mistakes. It’s likely that you’ll feel overwhelmed at times, so listen to what your body, mind and heart needs and give yourself some space to attend to those things. Your own health and wellbeing really matters. So if you need help – and most of us do at different times, then please talk about it and give it some focus. We need to take care of each other – it’s ok not to be ok. Only when we create supportive environments for each other can we bring our ‘A game’ and keep providing the phenomenal care, innovation and transformation that we do every day.

 

Thank you a million times for everything you are doing, despite the struggles and pressure. Together, we need to create a culture of joy and kindness. That is partly the responsibility of leaders, but its incumbent on all of us, to treat ourselves and those around us with gentleness and respect. Go ahead and keep doing the great work you are doing every day – you really are a wonder!

 

Love and gratefulness

 

Andy

 

 

 

 

 

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The Morecambe Bay Approach to Population Health – The Double Pentagon

In this podcast (iTunes or Spotify), I give an overview, as Director of Population Health in Morecambe Bay, about the approach that we have developed as ‘Bay Health and Care Partners’ (BHCP) around population health. The double pentagon model draws on learning from across the UK and the world, leading think tanks, like the Kingsfund and local communities. The model has been developed with Dr Jane Mathieson – our wonderful Public Health Consultant, who retires this month, Prof David Walker – Medical Director at UHMB, Marie, Spencer, Jacqui Thompson, Hannah Maiden and Vicky Hepworth-Putt. BHCP is an Integrated Care Partnership which includes the GP Provider Alliance, The University Hospitals of Morecambe Bay Foundation Trust, Lancashire Care Foundation Trust, Morecambe Bay CCG, Cumbria County Council and Lancashire County Council and is committed to ‘better health, better care, delivered sustainably’.

 

So – if you’re interested in Population Health and/or you work as part of one of the organisations within BHCP, then listen in, enjoy and let’s continue this conversation.

 

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World Autism Awareness Day

Autism affects so many of our lives and families, and yet so many of us know very little about it, make unfair assumptions about people who live with it, or make crass jokes about people, using it as a derogatory term. In this episode of the Black Swan Podcast, I interview, the amazing Deborah Brownson, who recently won an MBE for her incredible work around autism. I am so glad that she is here in Morecambe Bay, though her work has a national and international reach – and rightly so!

 

World Autism Awareness Day is a good time to talk about Autism! The podcast is full of profound wisdom from a woman who has two sons with Autism and is working tirelessly to raise awareness, change perspectives and create practical resources and support networks to help people who live with Autism and the carers who support them. I hope you find it interesting, challenging, comforting and inspiring. Here are the links to the podcast, depending on your preferences!:

 

iTunes

 

Spotify

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Recovery From Addiction – Podcast

Here is the lastest edition of the ‘Black Swan Podcast’ – available on iTunes, Spotify, Alexa and anypod.net

 

This one is with my good friend, Dave Higham, founder and CEO of ‘The Well’ – an incredible community of recovering addicts, here in Morecambe Bay. This one focuses on Dave’s own story through addiction and prison (where he’s spent more than half his life) and his journey of transformation and hope. This podcast is unmissable and (along with the next one, which is a group podcast with other members from ‘The Well’) has some of the best examples I know of how love and kindness practically restores lives and rebuilds communities – a prime example of the new politics and economics we need!

 

https://itunes.apple.com/gb/podcast/black-swan-podcast/id1454670907?mt=2#episodeGuid=Buzzsprout-984751

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Knife Attacks – Whose Crime Is It?

I find myself staring at the screen, unable to comprehend how utterly devastating it must be as a parent, to have a police officer knock on your door in the early hours of the morning, to be told that your darling child has been stabbed to death. My heart weeps for the senseless loss of life, young lives stolen away in this rising tide of violence. I know what it is like to break truly awful news to people and their families and my heart goes out to the police officers on the beat or the clinicians in the Emergency Department, who have to break the terrible news to the parents and the siblings, that so suddenly, a bright shining light in their lives, has been extinguished.

 

Knife attacks are a crime, there is no denying that, but the burden of guilt is not so easily apportioned. We are seeing an exponential rise of it in our streets, with a 93% increase in recent years across England, whilst in Scotland, they have seen a 64% decrease over a similar timeframe. We need to examine what has gone on in that time and ask some very uncomfortable questions. We also need to call people to account for decisions which have been made, despite knowing the evidence, and  we desperately need a ‘whole systems’ approach to tackling this epidemic.

 

The Primeminister has stated that “knife crime” is not linked to a decrease in policing numbers. The police chiefs disagree. The truth is, that it’s not only the police who have disappeared off our streets (and these are community police officers, who knew their communities well and were respected and trusted – it takes years to build up those kind of relationships) – we’ve had a perfect cocktail of cuts right across the board which is directly attributable to the mess we are now in. Ongoing austerity, which is a political choice, has also led to the closure of youth centres, more young people than ever excluded from school, (who then have a 200 times higher chance of being groomed into violent gangs) and massive cuts to public health and local government, meaning many preventative schemes have disappeared. When policy fails, it has to be called out and challenged. Everyone with a brain knows that prevention is better than cure. And for those who have lost loved ones, there is now no comfort – this could have been prevented, but has been allowed to escalate at such an alarming rate because we do not have a form of politics or leadership that listens to what is really going on in our communities, but continues to drive through ideological changes without thinking through the consequences. This is unacceptable.

 

When Heidi Allen MP came to Morecambe, she heard the testimony of my friend, Daniel, who grew up in some really tough circumstances, forced into a gang culture in order to help put food on the table and prevent harm coming to his family. Tears streamed down her face as she heard his powerful account of what it meant for him as a young person, to have his youth centre closed, his local high school closed and being told he was not a priority when he was street homeless. She told us that she had not realised the layers to the poverty that many are experiencing across England. And this is how the (perhaps) unintended consequences of remote policy decisions affect ordinary people in droves across the UK. When school budgets are cut and mental health teams are cut and social care provision is cut and youth centres are cut, children and young people from home environments which are already struggling to make ends meet, already processing significant trauma and adversity, fall prey to gangs and criminal networks who use them and abuse them for their gains across county lines.

 

And yet in Scotland, we are seeing an altogether different picture emerging, because they saw this problem 10 years ago and decided to make a difference by dealing with complex living systems, rather than tinkering clumsily with mechanistic thinking. So it is high time that England ate some humble pie and learnt from our Celtic friends.

 

Scotland, unlike the English, are not delaying on taking a serious approach to Adverse Childhood Experiences, hoping to become the first fully trauma informed nation in the world. They have taken a public health, holistic approach to the knife crime problems in Glasgow and then spread the learning across the nation, rather than making devastating cuts to their PH budgets. What they have done isn’t rocket science – it’s plain, public health common sense. They have chosen not to criminalise, label and stigmatise young people (something the hostile environment rhetoric seems to do). They have refused to see it as a race problem – because it isn’t (but some in our press in particular, and some members of the government have stirred up this nonsense anyway) and they have invested in early and effective youth intervention programmes, amongst other things.

 

One of things my work has taught me to do, is suspend my judgements of those who we would automatically and ordinarily point the finger at, the supposed perpetrators of a crime, and really listen to the truth. The truth here is complex and I’m not saying that people who commit violent acts do not need to face the consequences of their actions. They do. But what I am saying is that we need restorative justice in our communities that breaks this horrendous cycle. We also need to recognise that there has been terrible violence done to our most vulnerable children and young people across England by a series of political decisions. The government has failed those it should have protected. In my line of work, those kind of errors would lead to massive learning events and the dismissal of those who had failed in their leadership. Perhaps people have such little faith in the political system we have because there is seemingly such little accountability. Now is not the time for silly political defence of failure. Now is the time for humility, repentance and a genuine turning of the hearts of the fathers and mothers in the nation to the rising generation, far too many of whom are no longer with us.

 

 

 

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Adam Smith Was Wrong!

I have recently been at a brilliant gathering of people, down in Sussex, called ‘Sparks’. I always find it to be one of the more helpful imaginariums which I spend time at and love the diversity of the people who come. What follows is some learning I’ve taken from my good friend, Mark Sampson and his fabulous PhD thesis.

 

Adam Smith famously stated: “It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.”

 

Like Mark, I disagree with him! I do not believe that self-interest is the basis for individual interaction and whatever we are told, the unrestrained free market is not benevolent!

 

We have allowed economic language not only to inform reality, but to create it. The language and vocabulary of economics is performative – it creates the world around us. Why would we think that self-interested economics will lead to goodness in society when we do not believe that in other parts of society or our own lives? It is not true of our relationships in our families nor in our friendships, so why do we allow a split mindset in how we think about work?

 

Some economists (Robertson and Summers) have argued that we should promote self-interest in policies and act out of this same motive in business, but altruism in other areas of our life, like our family and charitable work. This is ludicrous!

 

As Kate Raworth has so eloquently demonstrated, this current model of economics is dividing us, isolating us and slowly destroying us. It may, in some ways have gotten us to where we are, but it is neither capable nor kind enough to give us the future that will lead to a more connected and healed society and a more sustainable planet. Enlightenment thinking holds very little light for us now. And so, it is time to let it go, to lament its failure and discover together a new language and a more sustainable model for a reimagined future. Some of this requires exchanging the language of scarcity to one of abundance, renouncing the doctrine of growth for one of equilibrium, repenting of our obsession with competition and embracing relationship and collaboration and replacing self-interest with the notion of gift, reciprocity and mutuality.

 

This requires us to dig deeper into a spirituality and a paradigm shift in our thinking which embraces incongruity! The beauty of mutuality is that it recognises that there is personal benefit to the giver as well as the receiver in any gift-exchange interaction and it strengthens the bond of relationship. Since I watched the Christopher Robin movie, I’ve been thinking quite a bit about upsidedown triangles. Our current economies are built in pyramids, with those at the top “earning” and holding absolutely vast sums of money. What if we gave our most and prioritised those considered at the bottom as the most important? In the NHS we think a lot about ‘equality and diversity’ but often do little about it. For example, most of our waiting rooms and clinical environments are incredible unfriendly for people who have an autistic spectrum condition (ASC). What if, when designing these spaces, we didn’t tag on some kind of tick-box exercise afterwards to show we’ve considered people with ‘disability’ in a vague sense, but actually put them at the forefront of our thinking and planning? What if people living with ASC were at the very forefront of our planning decisions? Incongruous, perhaps, but a different kind of economy, which feels to me to be altogether kinder.

 

In my last blog, I explored how it is isolation (and competition caused by our need to try and overcome our human limitations) which cases poverty. What might we imagine together of an economy in which we prioritise relationships first, and worked together WITH those often left at the bottom of the pile or tagged on as an after thought? What might our planning cycles be like, if we slowed things down and really collaborated WITH our communities and truly considered all the benefits of mutuality? I believe we are at a moment in which the facades are well and truly down. We can see more clearly than ever just how broken our current economic system is, the true effects of putting our faith in the ‘free market’ to create a fair society and a sustainable planet and the realities of allowing our policies to be shaped on the notion of self-interest. It would be insane for us to continue with such a broken model, but it will take ongoing bravery to undo it’s myth in our minds, breakdown the strongholds of the many vested interests and to be part of a corporate reimagining of something based on mutuality and even incongruity!

 

In the end, I believe that when we deal with our root issues and become more healed, we are far more motivated by love than self-interest – and I see this every day! We are made in the image of God but allow ourselves to believe much less of ourselves. To quote Charles Eisenstein, “it is time for us to tell a more ancient and far more beautiful story which our hearts tell us is possible.” What if Milton Friedman was wrong and the business of business is not business? I know that may seem ridiculous, but what if the business of business is to ensure that every life matters, that we are more connected and living in a more sustainable way? What if it was the business of business to make real what really matters to us all? What else might a reimagined business of business be? And what effect might that have on how we think about economics and how we collaborate for a more mutually beneficial society and planet? I think we see this in many models and forms of business already. There are some wonderfully ethical and gentle businesses – I think this is especially true of smaller businesses where relationships are both vital and strong. It is the impersonal banking sector in particular, built on an economy of debt, with multi-lateral corporate giants that holds us prisoner.

 

The reason I am writing about this on this blog is that so much of our health and wellbeing is governed by our philosophy of economics and it is the language of economics which shapes so much of our thinking and reality. So, be careful how you speak about it, find some better words and let’s begin to shape a new future together for the sake of the wellbeing of humanity and the planet!

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