Do all public services have to be delivered by professionals?

One of the most prominent 20th century proponents of ‘deprofessionalisation’ was the Austrian-born priest and philosopher, Ivan Illich. Illich railed against what he viewed as the ‘monopoly’ control of education and healthcare by teachers and doctors…” – my latest blog on public services and social innovation for Pioneers Post.



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4 responses to “Do all public services have to be delivered by professionals?

  1. Not always David,
    A recent connection has given the opportunity to collaborate on asset based comnunity development with a local trust who describe their 10 year plan as “all working together across conventional boundaries to enable people with disabilities and mental health challenges to take charge of their own lives and develop opportunities to help themselves, and others. ”
    This is congruent with how we see a people-centered approach to local economic development:

    It was inspired by Carl Rogers reasoned that helping people gain access to the resources they needed, could help them resolve their own problems, flourish and grow.

    “Originally described as non-directive, this therapy moved away from the idea that the therapist was the expert and towards a theory that trusted the innate tendency (known as the actualising tendency) of human beings to find fulfilment of their personal potentials. An important part of this theory is that in a particular psychological environment, the fulfilment of personal potentials includes sociability, the need to be with other human beings and a desire to know and be known by other people. It also includes being open to experience, being trusting and trustworthy, being curious about the world, being creative and compassionate.”

    As my late colleague put it:
    ‘Allowing that some people do not matter, as things are turning out, allows that other people do not matter and those cracks are widening to swallow up more and more people. Social enterprise is the first concerted effort in the Information Age to at least attempt to rectify that problem, if only because letting it get worse and worse threatens more and more of us. Growing numbers of people are coming to understand that “them” might equal “me.” Call it compassion, or call it enlightened and increasingly impassioned self-interest. Either way, we are all in this together, and we will each have to decide for ourselves what it means to ignore someone to death, or not.’


  2. Interestingly David it was some of these questions that sprang to mind for me while I was at the UKRF recovery event in Leicester at the weekend, where I bumped into your esteemed colleague Mark 🙂

    In relation to how people in recovery can best work with drug and alcohol services, I think there’s a huge role for volunteering and particularly peer support.

    The first step in accessing drug and alcohol services when you are beginning to recognise you have a problem can be a hugely daunting experience. In helping people to take that step, support from those who are stable in their recovery (peers) would in my opinion be a far more effective way of doing things. One could argue that the support of peers is also vital for a person’s continued journey through a service and into sustained treatment.

    Peer support should certainly be the ‘first face’ of the drug and alcohol service provider as I believe it would provide a more effective service and get more people into treatment. And that’s the point surely?

    Regarding the bigger picture there is so much mistrust between those who think public services and jobs must be protected at all costs and those who want to change the status quo that sensible change based on evidence struggles to get itself heard above the din.


  3. We don’t need more professionals, we need more community.


    • Community involvement is always good, but the extent to which volunteers can contribute depends on the professional specialism doesn’t it? I certainly want a professional GP to assess my medical needs , but I might opt for non professional ancillary services prescribed for me. I don’t see how purely voluntarily staffed libraries could cope with specialist work like deciding what books need to be ordered to meet local needs, or accessioning and classification, though I agree volunteers can help issue books, and shelve them. I can’t see how the complex needs of looked after children, or older people with multiple needs can be met by volunteers working alone. This needs a nuanced debate, and a clearer understanding of how professionals and the comma ity can get the best from each other.


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