State of loneliness

The government's new public services reforms focus on rights and entitlements, but, argues Charles Leadbeater, supportive relationships are key to tackling social ills
Elderly woman by window
Setting up social networks is seen as a way of helping elderly people on their own to be healthy and happy. Photograph: Alamy brt COMM / Alamy/Alamy

Everywhere you turn, organisations are desperately seeking new business models. The banks will have to make money in a very different way once they are rid of toxic debts. Media industries are in turmoil, due to the recession and the web eating away at advertising revenues. The car industry has been saved, but only to face long-overdue restructuring as it attempts to go green.

The price of saving the banks from disaster is a record fiscal deficit that will force public services to embark on their own search to do more with much less. The only way forward will be radical innovation of a kind that has been put off during the last decade of rising spending in the name of modernisation and reform. Whatever that approach has achieved - new buildings, better-paid staff, shorter waiting times, some improvements in school performance, less crime in some areas - it cannot be the recipe we adopt in the future.

The fiscal crisis has fully exposed the current model of public service reform - invest, modernise, set targets, review performance, eliminate failure - as having run out of steam. Public services may be more efficient, but all too often they are not joined up, leaving the people on the receiving end bewildered by what one elderly woman, who was being visited by four occupational therapists, described to me as a blizzard of services.

More efficient services quickly move in and out of people's lives, but they don't really change how people live. That is one reason why we have not made deep inroads into the most deprived communities, the most troubled families, the most intractable social problems. Services manage and process people and problems, but only rarely allow people to change their lives. Service solutions are ill-suited to the emerging challenges of the rise of long-term health conditions, diseases linked to lifestyle and diet, ageing or climate change. You cannot deliver a solution to an epidemic of diabetes the way that DHL delivers a parcel.

Feedback loops

The government's new approach, unveiled this week, to entitle people to personalised services, booked appointments and local policing is a step forward, but it leaves hanging in the air the question of how people will enforce their rights without more direct, personal control over the budgets used to commission services. One of the main problems with public services is that the feedback loops between consumers who want something different and suppliers are so elongated. The government's entitlements will work only if the gap is closed.


There are good reasons for putting relationships at the core of effective public provision. Relationships are at the heart of what makes for a good life. Living as a solitary individual, for most people, is a recipe for unhappiness. Much of what we most value - love, friendship, trust, recognition, care - comes from relationships with family, friends and social networks. People grow up well and age well if they have supportive relationships.

In Britain's largely service economy, earning a living turns on social skills, being able to understand and respond to a client's need. Innovation comes from our capacity to collaborate creatively. In an innovation-driven, service economy, basic social skills - how to listen, understand and work together - are as important as reading, writing and arithmetic.

Equally, relationships that collapse or turn sour are the main source of the bad life. Loneliness is reaching near epidemic proportions among older people: more than 50% of people over the age of 60 say they are lonely at least some of the time.

Families that live in a constant state of crisis, with children caught up in the fracturing, centrifugal and sometimes violent relationships of the adults in their lives, are another significant source of long-term social costs. Much of the challenge of youth offending, knife crime and gang culture comes down to malign peer influences: the wrong sets of relationships. Even among the affluent, there is a pervasive sense that life is increasingly organised through fleeting, often impersonal transactions, rather than lasting relationships.

Many social ills come from relationships that are dysfunctional. It follows that public services, especially around such things as social care, long-term health conditions, education dropouts, offender rehabilitation and family breakdown, should be designed so people can form or restore relationships that will support them. The challenge of the future is how public services can support relationships, at scale, without being heavy-handed. This is where some of the most exciting radical innovation in public services is emerging.

Lonely and isolated older people need simple and trustworthy ways to connect with other people who might share their interests. Westminster council is involved in developing a platform called Get Together, which uses telephone conferencing to get older people who live on their own to talk to one another. If that works, they can start visiting and going out together. Older people with relationships stay fit and out of costly health and social care for longer.

Often young people who drop out of school and feel at a loss need a relationship with someone to support, motivate and inspire them. That is why councils in Croydon and Brighton are working to redesign youth services so they rely less on bringing young people into youth centres and more on creating networks of peer support, so that young people can sample experiences and reflect on them together. The long-term cost of the thousands of young people who each year leave school with no qualifications, employment or training would be reduced if they had coaches, peer mentors and personalised development programmes.

Wider network

Swindon has a project aimed at families in chronic crisis, often in receipt of multiple services, from social workers to health visitors, and sometimes in and out of courts as often as they go to the supermarket. Again, the key is to provide a supportive relationship and a wider social network, to help people shape and take more charge of their lives. Services for the average family in chronic crisis in a town such as Swindon cost about £250,000 a year. An intensive, upfront investment in mentoring, advice, coaching and motivation, helping families to change how they live, would cost less and be more effective.

Older people in Southwark, south London, told social enterprise developers that what made them happy, fit and healthy was staying active, participating in society around them and keeping connected to other people. So now an enterprise called Southwark Circle is being created to provide a neighbourly network to help people with practical jobs around the house and social activities. Most older people want relationships that keep them active and give them opportunities to contribute, not necessarily day care centres that cut them off and "service" them.

The key to getting people to change their behaviour - perhaps to stop smoking, take up walking, or start recycling their waste - is whether they know and respect other people who do the same thing. In any areas where lifestyle change is critical to public policy - for example, helping people to tackle diabetes - peer-to-peer networks, often organised through mobile phones, will be vital. Relationships change the way most people think and act.

Effective spending

Of course, focusing on relationships and mutual self-help cannot be the solution to every public service challenge. Often, people need and want an effective service, delivered to them to collect their bins or provide an expert diagnosis.

The best way to make public spending more effective is to reduce long-term dependence on repeat service solutions by helping people devise alternative ways to meet their needs that will mean they do not need a public service. The key to that is not in tougher targets or new rights and entitlements, but in better relationships.

For most of the last decade, we have seen public services as systems and standards, to be managed and rationalised. Instead, we should reimagine public services as feeding the relationships that sustain us in everyday life.

Charles Leadbeater is a founding partner of Participle, which works with communities to devise solutions to intractable social challenges