TO THE RADICAL ELEMENT - Is there anybody out there?(This is a message for those who know they are Radical Thinkers, or who think they may be Radical and also for those who wish to understand the role better. This desire may either be so that you can make space for Radical Action, or, so that you can work to defeat Radical objectives and maintain the status quo): Hi, Radicals, everywhere, anywhere! Keep up the good work. We are slowly getting there but it is a never ending battle. Watch out for tomorrows radicals, they are on our shirt tails, but they lack confidence and are just moaning in the smoking room. They will need encouragement. I am glad to say we have just about taken the banner back from the likes of Maggie and Ronald. Son of Maggie & Ronald fight on, but we no longer have to appear 'reactionary' to their 'quasi-radicalism'. There is such a thing as Community, and together, we are re-building it all the time :-) Being a Radical Thinker is hard work these days. We are relatively isolated because managers of institutions have learned to 'mimic' Radical Action for themselves. They have taken on the 'sound bite' and 'bullet point' presentations of the media and used these to give the impression that they are up front, in the lead, and advancing the needs and wishes of their clients & patients. It is all nonsense, of course, but is is a great money spinner - professionals are now well paid administrators of paperwork systems, supporting a host of admin and managers, safe in the knowledge that things are so well tied down that little can go wrong for them, in theory. By the time the institutions have paid, or allocated funds, for executive and line managers, the buildings and their services, security systems, paperwork & computerised recording systems, none professional staff, etc., more than half of the limited funds have been assigned from the available budgets. The actual figure can be much higher. Of those remaining funds, which are supposedly allocated towards the direct costs of employing professional staff, to provide, or organise, direct services to patients and clients, the equivalent of more than 50% of time is allocated towards administrative duties, like recording, funding & service requests, training and attending meetings, etc. In community services, add to this time cost, travelling time (especially in rural communities) and anything like 60%-80% of time is taken up with activity that does not involve 'any' direct contact, or benefit to the client, patient, or family carers. It is activity to justify costing and to reduce risk of litigation to the institution. Where does the Money Go? Best of luck community. By the way. If you hope to obtain Charitable support, or improved assistance from a Non-profit organisation, best of luck again. You want, instead, to get a high quality, normalised, responsive service, at reasonable cost, purchased by yourself, for you, or your family member? Think again. All organisations are now required to meet the same, contradictory requirements for providing an adequate, good quality of service, in the least restrictive way, focused upon the individual, at best value, at minimal, managed risk, while; Meeting the obligations of professional bodies and registration agencies, which restrict anything but the least risky activity. All of which is paid for by the registering individual, or service agency and yourselves. All services, public, private and charitable, are now so heavily restricted in their actions and are required to record actions and events in such detail, and operate time consuming process for all requests for services and funds to provide to service users, that only a relatively small fraction of the time and resources are directly available to the person. The agencies & institutions that are assigned the role of imposing and managing these requirements and restriction, themselves cost the tax payer. This cost is nominally assigned as being part of the service provided to the person in the community. If you do a simple sum, this means that the cost benefit, in terms of a direct service to the community, is substantially less the 25% of the original funds allocated. In fact, it is often much less, but you can rest assured that it will all be fully justified, to your satisfaction, though the Audit Commission and other, local financial audits. Now, does this make your service safer, or of a higher quality? Does this put service users and staff at less risk, apparently not, risks are increasing. Has this significantly reduced the risk of litigation towards the institutions? No - it has actually increased the level of complaints, in spite of increased apathy. The indications are that litigation will continue to increase. Thinking outside the box? They need putting in one. Being Radical, say 30 years ago, required us to be: - reasonably educated and highly emotional, or passionate, about the issues that affect people lives, including social injustice, corruption and wastage;
- have our ears and eyes open to the realities of life and the vulnerabilities of our relatively isolated role;
- optimistic in our beliefs that things can be improved but that this will require copious amounts of time, energy and resilience and very little thanks.
- faith in the abilities of people to be able to change their own circumstances, with the support of those who have requisitioned some of the institutional power;
- secure enough in ourselves that we can give over this power to the people we support, sit in the background and provide a 'feed' to community empowerment;
- confident enough in our own abilities that we can let go of ideas and watch others take them away and sometimes corrupt them out of recognition;
- able to step outside the box and think the unthinkable, risking being described as delusional, idealistic, communist and other rather abusive & ignorant accusations;
- an adherence to fundamental principles and ethics, without compromise, with politeness, good humour and humility, especially when we get it wrong.
- (TO BE CONTINUED - Please add your suggestions by email)
This combination is still fundamental to Radical Thinking, although the education does not have to be of the institutional kind, if fact, these days it is best that it is not. We still need take care, to watch out for that point where we may dismiss and otherwise put down, the advancing of ideas & practices of our newer colleagues. Sometimes these ideas and attitudes will contain prejudices and may tend to be retrogressive in some ways, but often they will include positive challenges to us all. We should always listen & take up the challenge. This is what keeps ideas alive and our professions advancing out of the twilight age. It is a learning process. It is not a required part of the job to be 'radical' and it should never be. This would make collective professional practice and teamwork impossible. It is a separate role that we may choose to have and use to press for improvements and efficiencies in the services that we provide. There is a constructive role to be had but it has to be accepted that it is to one, or other, side of the debate of mainstay services and the professions. Without radical action there is only change, never advancement. For better or worse, there are constant changes in these services and the professions, mainly in terms of attitudes and practices. There are constant pressures form media, government and community. The responses are often 'reactionary' by contrast. That is, put very simply; reacting to pressures, criticism and prejudice, often without adequate thought to the wider and longer term consequences. These are often very defensive reactions. The terms 'reactionary' means little more than this. The modern radical perspective has to be well thought out by contrast. Emotion is no longer enough but should remain in the form of passion. The other important consideration is that even with the most careful phrasing and illustration, those good practices that are put forward, often become distorted by the time Government and the Professional Bodies get 'half a hold' on them. When the media and communities get to the point of saying that a 'new idea' has failed, this is often because it was not the new idea, but an old one, repackaged in the wrappings of a developing new idea, often using its language. For instance; Community Care is not failing. It is the poor integration and failed professional understanding, often at more executive levels, and from within the 'old school club' of institutional thinking, where there may just be the nominal adherence to the 'notion' of the advancing principles. In the main, the fragmented and disillusioned communities struggle on, still feeling inadequately supported. This is the impression that I get from talking with people in need in Europe and USA. And they are inadequately supported. The necessary resources are there, relatively unskilled and begging to be activated. They are becoming increasingly despondent because of the inefficiency and limited horizons of the service providers and funding agencies. The funds to support most community initiatives are minimal but control freaks have to put in a whole raft of controls and protections. That requires a lot of work for them - so, it doesn't happen. (To be continues ... ) MOTIVATING COMMUNITIES & SERVICE USERS: If you would like some clear guidelines on how to motivate communities, service users and cares to co-operate to advance and improve service, then please ask. These are available. Just indicate what it is that you want to achieve and we will provide extensive guidelines on how to package and present them. The section on the general principles involved in motivating communities and service users, is still under construction. We are currently taking account of the particular difficulties that are faced by more Rural & Dispersed communities. Adventurous community initiatives are still operating and developing in the larger cities and ghetto's. Rural and otherwise dispersed, or isolated communities have a harder time of it and lag 20 - 30 years behind by comparison. These new initiative are best initiated for and behalf, and in the name of 'service users' and members of the community, not in the name of particular professions. Professionals should seed and then support these initiative but they have to be 'owned' by the Service User groups and community and they have to get the credit, or these initiatives will die like all things institutional. Here is a useful set of messages to give our more institutionally minded colleagues and managers: If there is one thing worse than resting upon you Laurels, it is resting upon other people Laurels. We can keep improving and keep a critical perspective on what we are asked to do in the name of our clients. This radical concept has been repackaged as if invented by modern health & social care as 'Reflective Practice. The difference is, its requires us to just reflect on ourselves, not the institution. Both reflections are required. There is not just a requirement for on-going training, which artificially includes the principle of 'reflection'. Reflection and improvement should be a natural inclination, just slightly more conscious than the level of 'intuition'. Reflection is the minute to minute, comfortable acknowledgement of what is working and what has failed, correcting errors as we see, or make them. Hopefully we are looking for these errors, if we are not totally convinced we are right all the time. The slightly artificial exercises that we do at college are to get us into that positive and considered way of doing our job. The are not meant to be something we just do now and then, as an exercise. Keep a critical perspective on yourself, others and the institution. Don't just moan about how things are. WE CAN KEEP IMPROVING THINGS, LIKE OUR BRAVE AND COMMITTED PREDECESSORS DID. THEY HAD LESS TO GO ON WITH THAN US AND FEWER MATERIAL REWARDS FOR DOING SO. More to come . . . What makes us tick? Radical Colleagues. We only occasionally have the chance to meet up but our objectives remain mysteriously the same: Is it your desire to empower yourselves and other service users? To adapt professionally to changing needs and demands? In doing this, do you seek to do so without loosing the essential qualities that gain the respect of those we assist? Are you willing to take calculated risks, in the interests of others, sharing this with others & acknowledging when you get it wrong?; Then you are radical enough. Please email us with what other qualities you think are important and criticisms of our site and these ideas. Apathy and grumbling have no potency and feeling frustrated and powerless is a disservice to our clients. We own it to them, ourselves and our colleagues, to remain sharp and positive. NOTE: Remember also, there are such things as Conspiracy Theories, that is why they have been given this name. The point is; Is there any substance to them? :-) Mostly the cock ups we continue to experience in health and social care are due to collective ignorance rather than conscious design. These are the consequence of blaming others, without reflecting upon their own practices. Conspiracies? There are probably a few loose ones but mostly it is collective cock-ups and institutionalised, 'non-thinking', automated reactions, along well established, self protecting and self-interest lines. Conspiring take to much effort , requires dynamic organisation and quite sophisticated thinking. It is unlikely to ever happen in health and social care.:-) See: Conspiracy Theory. | RADICAL NEWS UPDATES: Primary Health Care:
UK GP's have got a great deal, as have Consultants. The Junior Doctors situation has also improved a little over the last few years. Best of luck to them all. Unfortunately, established GP's have also lost energy, having won a personal lifestyle battle. We can expect less Radical Action form them these days. PCT's (Primary Care Trusts) are now mini institutions in their own right, self protecting and self congratulatory, like their Hospital and Local Authority counterparts. They are run by mainstay GP's and professional administrators. Its all about accounting & litigation. Its about 'control'. UK Junior Doctors seem to have retained their radical streak, however. There is some hope for the continued development of Specialising Expert GP's and the future of 'Radical Elements' within Consultants is also reasonably assured. There is also hope for the long promised, truly multidisciplinary Neighbourhood Teams, some time in the future. Presently, I fear Neighbourhood Teams and GP Clinics will be little Empires of closely allied professionals and under-trained, underappreciated, social care workers, who the mainstream GP can maintain some control over. PCT & Continuing Health Care:
Returning to PCT and considering CHC (Continuing Health Care) funding; What is going on? First you have it then you don't! After years of playing God with allocations of funds and services to people who are desperately in need of them, the Government (who persistently underfund services) sends out and edict, with clear guidelines to ensure a more consistent and fair allocation of funds to those desperately in need of specialist, or intensive health care within the community. With the usual fanfare of optimism and enthusiasm, we all get trained up on the new systems, with promises that there will be a farer allocation of funds and clearer criteria for identifying health care needs and funding entitlements. All the indications were that this had been achieved, at last, with a challenge 'to get it right' in terms of Metal Health and Dementia Care. In our patch the assessment process was effectively limited to Nurses. Other, specialist health care workers, including Mental Health Social Workers were effectively excluded (contradicting the guidelines). This may have something to do with the fact that we tend to challenge decisions more. The result! Little difference in the actual fair allocation of additional funds within the community, especially for specialist health care needs & particularly Mental Health. All the more strange when you hear the argument that Mental health is, by it name, a Health Care issue. Once an institution always an institution. Change by virtue of the changing of the names of processes only. Same old protected and unjust service to those with the greatest needs and least ability to vocalise them. Get a life will you, health care administrators, try to remember your original 'ethical' & moral commitment, and while doing this: Do you recognise the bit in the CC&HS legislation where it describes how we are to 'assess according to (clinical) need', without consideration of costs, 'then' identify the resources required to meet the need, 'then' allocate appropriately that which is available, 'then' record, publish and feed back to Manager & appropriate government agencies, the identified shortfalls. Some 16 years ago I remember having this discussion with a Team Leader in a CMHT. In that instance the assessments were being done 'explicitly' on the basis of the resources available to the service at the time. Staff were instructed to do so, by Memo. I explained to them, that doing this would mean there was no way to identify if there was a shortfall of resources. It was clear, even then, both in Health and in Social Care, that there is an active tendency, by some managers and a few practitioners, to protect resources in this way (WE ARE REQUIRED TO PROTECT RESOURCES, AS RESPONSIBLE PRACTITIONERS). By pretending that there is NOT a particular level of need and demand we are doing a disservice to our patients and clients, hiding the need and demand is dishonest (IT IS PROFESSIONAL MALPRACTICE BY PRACTITIONERS AND MANAGERS). We are obliged to find and use an honest method, disclosing to clients & patients how we can not meet their legitimate needs in the way we assessed as most appropriate. It is also stated, local policy to do this, although how its is to be practicably done can be problematic. Community Heath Care:
The development of Community Health Care services continues. Some of these are closely managed by GP's but there are also relatively independent practitioners & teams, within the community already. In fact, Community Health Care practitioners look to become more definitively independent practitioners than their Social Work counterparts. This has to be good news for Health Care Services. Any moves like this will tend to reduce the tendency towards institutionalisation and provide the opportunity for practitioners to be more responsive to patients needs. This aids the potential for Radical Thinking and provides potential for further challenge to the general institutionalising and quasi-commercialising tendency of health services. The increase in Community Health Care Specialists is good news but these tend to be tightly 'managed' within specialising Health Care Trusts. This means that the tendency towards independent practitioner status is inhibited. Specialist Health Trusts tend to be quite conservative, protectionist and defensive. The tendency towards Micro Management takes away Professional Autonomy and reduces professional initiatives. Radical Thinking under these circumstances is very difficult. The professional roles tend to become very defensive in these circumstances. Such Trusts are tending to fail, however, and we may see newer, more 'open' systems for managing Community Health Specialists in the medium to long term. Hospitals Services:
Everyone seems to like to knock hospital services at the moment. It is the privatisation of the hygiene & hotel services that started the current deterioration in standards. Poorly paid and poorly trained staff, working with little respect, or appreciation. Little in the way of recognition as part of an important health service, in spite of being perhaps the most important bit of it, when it is done well and with adequate resources. Paramedic Services:
More work, more responsibility, more accountability, more commitment, more enthusiasm, more rules, more don'ts than dos, poorer work environments and conditions for relatively poor wages and significantly less say. Less colleagues, less vehicles, less support. Come on fellas, speak up for yourselves. We know what you are up against To Come. Definitions: Radical:
Why do we describe ourselves as Radical? This stems from a very clear definition of the term, as used in science. Free radicals are 'open' [shell], highly reactive and keen to bond with other radicals & reactive entities, while retaining their own special character.
Thus, this concept of Radical is associated with the potential to be open to change: responsive and reactive to knowledge, experience, ideas and other perspectives. While being thus, they also remain true to their own character and expanding knowledge & experience.
‘Change is in all things sweet.’ Aristotle
(but never change for change sake. Terry C.)Positive Change:
In this way Radicals fit into the existing dynamic system and promote improvement changes (as knowledge develops) and ensure the established system (of the time) remains fresh and energetic; avoiding stagnation and decay.
Anyone that effects positive change, over the blind maintenance of the status quo (or self interest), can consider themselves to be Radical. If this describes you in any way, please join us and support the cause of alternative, person and community centred, perspectives and practices.
‘We must change in order to survive.’ Pearl BaileyMal-adaptation:
This mal-adaptation of some individuals to their families, culture and communities, extends to most serious 'mental illnesses' and much criminality. This includes schizophrenia, bipolar conditions, clinical depression, & most addictions; All of which can be 'pragmatically' identifiable as negative consequence of the mal-adaptive expression of our more creative human propensities.
Social Dynamics, Rule 1 is; to every action there is an equal & opposite reaction (external &/or internal). Rule 2 is: In circumstances, where there are restrictions on the positive, or constructive expression of inherent abilities (of any kind); distorted, distressing & destructive expression will ensue; in some identifiable form.
This will be evident in the internal psychodynamics, expressed thinking, gross behaviour and the general social dynamics of individuals and groups. The more immediate, consequential 'reactions' can be directed inward or outward, but the ultimate consequence is a negative social outcome. a destructive outcome or loss of social benefit.
See Genetics Unplugged Adaptation:
More of this is explained else where. Our role here is to help you appreciate the potential, skills and knowledge you possess and get our cultures & communities to appreciate the positive potentials more fully, allowing you to realise a 'healthy' adaptation of your propensities & abilities, within your cultural and community milieu.
It is our broad argument that human adaptation extends beyond mere biological determinism. The adaptation is two way and human beings are adapted to be adaptive. We have the extraordinary ability to adapt our environment and our bodies, to our prevailing personal / social dispositions & inclinations. We can even 'actively' change our body chemistry, through our behaviour and thinking, or through medical interventions.
Many animals can do this in some measure but we are so close to this capability that we are largely blind to it. Our abilities are principally expresses as anecdotes and 'alternative' explanations, rather than serious scientific explanations.
See Genetics Unplugged
‘Those who have changed the universe have never done it by changing officials, but always by inspiring the people.’ — Napoleon Boneparte (No I'm not deluded, Or paranoid. And of course, if you stop inspiring the people, 'they' change the Leaders (one way or another) |
