Don't let the excitement of a 'public health approach' become a Fyre Festival

By Chris Wright

| 26 April 2019

"Politics is a strong and slow boring of hard boards. It takes both passion and perspective" Max Weber.

Simple ideas are seductive. A fresh way of thinking is motivating and, when captured in memorable language, can be potent. Nothing would ever change without a compelling illustration of what the future could or should hold. But rhetoric alone doesn't solve problems and an emphasis on ‘why' and ‘what' without understanding ‘how' leads to disaster. We are surrounded by cautionary tales.

Exhibit 1, 2017's Fyre Festival. The vision of a luxury music festival on social media was enough to attract sponsors and bands, and sell 40,000 tickets. "If you brand it they will come." They did come, but the organisers had underestimated the mundane logistical realities of a three day event for 40,000 people: enough loos, hygienic food storage, smooth transport from the airport.

Exhibit 2, Theranos. Charismatic engineering undergraduate Elizabeth Holmes dropped out of Stanford to ‘disrupt blood testing'. She raised hundreds of millions for her medical technology company and her vision of democratising healthcare. With a single drop of blood, deposited in a convenient high street location, we would all have the power of early diagnosis, and know our susceptibility to hundreds of conditions. Stanford medicine professor Phyllis Gardner had explained to Elizabeth that this wasn't possible but the culture of ‘don't bring problems, bring solutions', and ‘move fast and break things', was more attractive. If one expert isn't saying what you want to hear, plenty of others can be found who will. 

Why is this relevant to public service improvement? We are not immune from the fetishisation of innovation, or from lauding new and shiny things. Innovation should never be an end in itself. In tackling the oldest and hardest social problems - addiction, violence, crime - it's often the case that what's effective isn't a new idea, and what seems new and exciting might not be effective.

Exhibit 3, the current vogue of a ‘Public Health Approach' to youth violence. Intervene early, focus locally, work coherently in schools, social services, policing. It's very sensible, but by no means new.

On the one hand, that these principles are making it into headlines, speeches, and policy strategies is good news. On the other, the creation of a ‘legal duty to work together' is the equivalent of a Fyre Festival Instagram image. As Louisa Mitchell of the West London Zone knows, an effective local approach involves the ‘strong and slow boring of hard boards'. Ask Corin Morgan Armstrong about the factors of success behind HMP Parc's award winning Invisible Walls programme and he will likely cite the relationships of trust between prison and probation officers, local teachers, employers and charities, built over many years. He would be too modest to mention his own consistent, expert, leadership over nearly a decade. Leeds DCS Stephen Walker has cited similar local relationships, tenacity and consistency in explaining his outstanding achievement. Gary Wallace's work in Plymouth shows how to be more effective and efficient by trusting people to solve problems, using the simple tools of human relationships and time. 

Getting people across a whole community to understand a shared goal, and the specific part they need to play in it, is a slog. Visionary rhetoric is necessary but not sufficient. Helping them to make the necessary changes to the way they work, and carry on making them, is an even bigger slog. We can't expect it to happen overnight, and the work will continue long after the next shiny idea hits the news.

There is no one ‘vaccine' for youth violence. It's irresponsible for any of us (just as it was for Elizabeth Holmes and Billy Mcfarland) to pretend there are simple shortcuts. We can think innovatively, and encourage each other to innovate, while also valuing the basics. People with jobs, supportive friends and family, and somewhere to live, commit less crime. Let's spend less time ‘delivering innovation' and more time helping each other solve hard problems. 

Chris Wright is chief executive of social business Catch22

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