Innovation in Social Welfare and Human Services

Rolf Rønning, Marcus Knutagard

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317910992
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

Innovation is an oft-heard buzzword in both public and private sectors concerned with the organisation and delivery of services to vulnerable individuals. This thoughtful volume explores what innovation might actually involve in the context of contemporary human services.

Highlighting both the importance and utility of innovation but also promoting a more reflective approach, the book distinguishes between innovation and improvement and discusses the relevant differences between private sector, public sector and non-profit organisations. It looks at how innovation is often as much a result of the power relations between the involved actors, and the structural context, as a result of popularly identified 'drivers' and 'barriers'. Including numerous case studies, the book illustrates and explains innovations in welfare services at different levels, looking at the macro level (innovations in social policy), the meso level (innovation at organisational level) and the micro-level (user-driven innovations).

Arguing the innovation is nothing new in human services, the authors emphasise the importance of innovation being developed and supported by those working within those organisations. New and creative solutions to problems encountered in everyday work by front-line workers can be taken up to improve services provided and make a difference for the users, rather than change being externally imposed upon them by those without insider knowledge.

Innovation in Social Welfare and Human Services is an important read for researchers and practitioners interested in the administration, leadership and organisation of social services.

1
Introduction

If we are to better the future, we must disturb the present.

(Catherine Booth)¹

Introduction

Like Catherine Booth, most people are, and have been, engaged in improving the quality of life for themselves or other people. This book is written for students, practitioners and researchers in social welfare and human services, many of whom are concerned with improving the quality of life for vulnerable groups. This book may hopefully give some new perspectives and inspiration for this work.

Both service users and employees within social welfare and human services are facing the demand for more efficiency, and the consequences of efforts to realize it. Employees can feel inadequate even when they stretch the rubber band too far. Into this context, innovation is introduced as an imperative to be even more efficient – one more demand. It is not surprising, then, that people in this sector seem to be rather reluctant to join the innovation bandwagon. That is, at least, our impression from our communication with people in the field. We know that staff are continuously concerned with improving services, but it may be a big step to use knowledge and tools from innovative work systematically in their own efforts. The sector needs new and creative solutions, and it is important that these solutions take into account the special demands in the sector, both the tacit and the codified knowledge of service users and employees. They should be the innovators, rather than being “innovated” by others. If not, we risk throwing the baby out with the bathwater. We hope that this book can both save the baby and inspire new and creative ways of thinking in the field.

Innovation has become a buzzword, and seems to be positively loaded in the public debate. Many experts are eager to impose on us their version of what innovation is. Welfare services are very visible aspects of public expenditure and are important for us all. We still have unmet expectations of the services, despite an increase in the budgets. Doing things better is of course possible in these services, and people in the field should be the main contributors in realizing this.

This book is meant to give a framework for such an engagement.

When we think of innovations, we still most often envision types of tangible object made of plastic or metal – maybe technological gadgets or inventions (Nelson 2011). However, innovations can also be non-tangible, such as new ways of organizing a service. We argue in this book that the welfare state can be seen as an innovation. The welfare sector might not be the first thing that comes to mind when we think of innovation. During the industrial era, the focus was on technological innovations, but the emergence of service-based societies has created an increased need for innovations that are social in nature. Critical junctures, especially during a time of crisis, can bring about systemic change. During these transformative periods, the possibility for new innovations to take shape grows. Understanding a crisis – realizing that we cannot continue doing what we have done before – can give fertile ground for systemic change.

“Welfare” means that people should fare well through life’s various stages (Daly 2011). Welfare also has to do with people’s living conditions in terms of opportunities for a reasonable livelihood, whether they have an attachment to the labour market or not. Welfare includes health, housing, working conditions and basic social security.

Social networks, private companies, social enterprises and NGOs can all be producers of welfare services, but if a society wants to create rights and basic social security for larger groups, public commitments are required. When these commitments are met, one can speak of a welfare state.

The term “welfare state” came into general use after the Second World War as a designation of democratic countries with market economies and comprehensive social policies (Olofsson 2009). Sometimes the term “welfare democracies”, or “welfare societies”, is used for countries with well-developed welfare services.

Since the same welfare services can be delivered by many different actors, Esping-Andersen (1990) introduced the term “welfare regime” in a comparison of the European welfare societies, to describe differences in delivery models. The public sector (the state and municipalities), market actors and civil society can all be service providers. Civil society, or the third sector, includes here non-profit actors, neighbourhood services and family care.

Different countries have developed distinctively different combinations. The Scandinavian or “social democratic” model gives much of the responsibility for establishing, financing and providing the services to public authorities. The “liberal model” (the US, the UK) leaves more to the market, while the “continental model” puts the responsibility for many deliveries onto the third sector, and also through participation in the labour market. All of the regimes can be said to be welfare societies, but the environments for innovation are different. New combinations of service providers are created today, both hybrid organizations and social entrepreneurs. These new constructions have their own balancing acts. They have to handle different institutional logics that are not congruent (Gidron and Hasenfeld 2012). They will be discussed further in Chapters 3 and 4.

Social policy is an important instrument in welfare societies to prevent and solve social problems and create social security. One of the tasks of social policy is to provide various benefits to people in cases of work injury, unemployment, old age, parenthood and illness. Another task is to produce or administer various welfare services within health care and social services. There is a clear connection between social citizenship and the welfare society, and the membership rights are most comprehensive in the Nordic model (Nygård 2013; Johansson 2008).

The need for innovation in the welfare sector has differed during different time periods. During the rise of the welfare state (1880–1940), several large-scale reforms took place in Europe. The period after the Second World War (1945–1980) is usually seen as a period during which we had a “strong society” with high employment and high economic growth, generating high incomes for the public sector. This provided opportunities for further expansion and refinement of the welfare state, such as the expansion of day-care centres and schools, and of higher education. The period was also marked by a significant optimism.

The emergence and consolidation of the welfare state have been characterized by ambiguity, ambivalence and struggle. The type of large-scale reforms, of which the rise of the welfare state is an example, can in today’s language be called innovations – and several welfare state reforms may be seen as radical innovations (see Chapter 2).

Women entering the labour market during the 1970s and 1980s created a radical change. This contributed to a great need for childcare and parental leave. Several convergent factors and changes created a demand for new solutions to deal with newly arising social challenges. One solution was to build a functioning parental insurance system. Since the scope and speed of women’s participation in the labour force varied between European countries, the public engagement in offering these services varied. While social security for (male) workers had been dominant in welfare states before the Second World War, women’s entrance into the labour market created a need for care services (Anttonen 1997), both for the elderly and for children. In Nordic countries, the public sector took the main responsibility here, and they now have a very high female participation in the workforce. In countries with different welfare regimes, the public sector was also engaged in this work, but the provision of the services was shared with other actors.

Since 1980, there has been a re-examination of the “strong society”, and the public responsibility for welfare services has been questioned. The growing cost of the public part of the pension system has triggered a remodelling of the system in many countries, and the burden of the growth is now to a larger extent carried by pensioners themselves. The main challenge has been to make the system both economically and socially sustainable. Low birth rates in Europe and an increasingly ageing population have raised questions whether we will have enough carers to care in the future, and also worries for the costs. Many countries in the Western world today are trying to develop a cheaper and more efficient welfare system. The restructuring of the welfare state and welfare services is evident. Parts of the welfare state have been questioned.

One solution can be to decrease the scope of services offered and let people take more of the responsibility themselves. In many cases, such withdrawals will have a social bias and hit hardest those with the least resources. Changes are always a choice between values.

Welfare deliveries have also begun to take other forms, such as the privatization of services previously provided by the state, an enhanced role for third sector organizations, and increased competition. In this context, the call for innovations and innovative strategies has increased.

The sharing of duties between public and private actors has often been a source of conflict between left- and right-wing politicians, where those on the left wing have wanted more public responsibility than their counterparts on the right. Since the late 1970s, neo-liberal and right-wing politicians have gained political power in many European countries, and these neo-liberal winds have also contributed to move the position of the left. The neo-liberal model for reorganizing the public sector, New Public Management (NPM), therefore also received support from “modernized” social democrats (such as Tony Blair in the UK). This change of the political landscape has definitely triggered the search for innovations within welfare services. NPM will be discussed at greater length in the following chapters.

When the business sector can point to studies that conclude that 50–80 per cent of economic growth depends on innovation and new knowledge (Helpman 2004), then it is not surprising that innovation receives much attention. If we use this estimate as the model for the “improvement” (and savings) innovation can bring about in the public sector, the pressure to innovate will be significant.

There are several reasons to be interested in, and to believe in, the effect of innovations on social welfare and human services in particular. Examples of cost reductions in private business are mentioned. Technological developments and innovations promise both to improve welfare and human services and to make them less costly. The expectation of innovation in welfare and human services is high on the political agenda and many put their trust in innovation as a solution to the problems that we are facing in a globalized world – in both developing and developed countries. In developing countries, innovation is considered essential to promoting social development. In developed countries, innovation is the solution to sustaining social welfare and human services without increasing the tax burden. The EU wants, through its Europe 2020 strategy, to create smart, sustainable and inclusive growth for all, even the poor. The EU stresses the importance of finding new and innovative solutions, especially in the social economy. However, so far no really revolutionary and radical solutions have been launched.

Public organizations, and particularly welfare services such as care and social welfare, are often seen as cumbersome, sluggish and not so innovative, in contrast to the dynamic and innovative business community. However, some studies show that there is more innovation in the public sector than in the private sector (Earl 2002; Earl 2004; Koch et al. 2005). The public sector is, and has been, an active driver of innovations:

most of the radical, revolutionary innovations that have fuelled the dynamics of capitalism – from railroads to the Internet, to modern-day nanotechnology and pharmaceuticals – trace the most courageous, early and capitalintensive “entrepreneurial” investments back to the State.

(Mazzucato 2013, p. 3)

In this book, we want to direct the gaze towards innovations that are emerging in the public sector in order to address social problems. Market actors and voluntary organizations can carry out the welfare services that are created, but the responsibility for the provision and funding of welfare services still falls on the public sector. Welfare is a very broad concept and covers a range of areas. Our examples of innovations are collected primarily from the public sector.

A few words about the terms. The focus of this book is on social welfare and human services. These terms are used in different ways, and to cover different services in different countries. In textbooks in the UK, for instance, it has been common to include education and housing in discussions about social policy. In Nordic countries, education is a separate field. The term “human services” might be more recognized in the US. Human services are services that are directed towards people. In some ways, human services can be seen as including not only welfare and health services, but also social work. Sometimes a distinction is drawn between human services and social work, where the latter is seen as being conducted by professionals who are “street-level bureaucrats” working directly with their clients (Lipsky 1980). Human services tend to be described as having a more managerial focus. The term has also been used for a movement, based in human psychology, that wanted to put more attention on the whole person than specialized disciplines within welfare services were supposed to do. In our book, we use the terms to cover the services dedicated to helping people to have a “normal” and decent life. Many professionals contribute here, from medical doctors, psychologists, social workers and nurses, to occupational therapists, speech therapists and others. We hope our book is relevant for everyone who spends parts of their life in increasing the quality of life for other people. The challenges for the services are also challenges for all of the contributors.

In Chapter 2, we define the term “innovation” and take a closer look at how it is used and its origin. We also discuss some of the common taxonomies in the literature on innovation.

In Chapter 3, we focus on social innovation, and especially on the social innovation process.

In Chapter 4, we discuss the particular significance that innovation has within the public sector and how the concept can be understood within this realm. When innovations are taken into the public sphere, they become part of the political struggle in society, and different groups aim to realize their interests through innovations. Political power is important for realizing, and understanding, how innovations are decided and implemented. This is discussed in further detail in Chapter 5.

In Chapter 6, we highlight social innovations with the help of examples of innovations at different levels. We distinguish between innovations at a macro, meso and micro level. The different examples of innovations are intended to shed light on how innovations at one level also affect other levels. We will highlight user-driven innovation and how service users themselves can be a driving force in the social innovation process.

In Chapter 7, we discuss common obstacles and challenges to innovation, in addition to those mentioned in the previous chapters. In spite of the fact that many people want to innovate, it is not easy either to get support for or to implement creative ideas in practice.

In the final chapter, we describe and discuss some strategies that can be used to innovate within welfare services. Many roads are accessible if we want to start the journey towards establishing a culture of innovation.

A purpose of this book is to demystify the concept of innovation, while also drawing attention to the innovative work that goes on in the welfare sector. It can be difficult to observe innovation practices since they are often gradual and slow processes. Changes within welfare services seem to be incremental rather than radical transformations. Institutions within human services have a tendency to fall for fads and other trends, of which only a few will be sustainable innovations (Best 2006). It is interesting to see that a method that has been abandoned in one context can find a new application within another organizational field. Brunsson (2006) points out that organizations often try to reform the work they do so that they will be more rational. However, reorganizations rarely lead to fulfilling this goal. Hopefully this book will encourage readers to develop a critical and reflective approach to innovations in their own sector. At the same time, we hope that readers will be creative and use their own expertise to innovate.

In this book, we use the term “innovation” for much of the change and development work that has been going on in social welfare and human services. We do this because “innovation” has become the accepted term, and because the concept of innovation, in the way the term is used today, involves a broad variety of activities.

Note

1 Catherine Booth (1829–1890) est...