The challenge of providing social services in complex societies

 

Some thoughts on what we need from our social services sector, the limitations imposed upon it and how using evidence and improving numeracy can help

Managing the limitations of service delivery
Sector level leadership is very difficult because of the variety and complexity of services and their consumers. Assessment and exchange of experience and information is hard to systematise at all levels so that sharing of systems, practices and operational processes across agencies has usually been piecemeal. Compliance with the Privacy Act 1993 has at times become the excuse for not sharing.  Some public and community sector providers have had their roles narrowed (“not our core business”), exacerbating difficulties in adapting to the increased complexities in social service needs.  Recent initiatives such as the Integrated Safety Response pilots for family violence have highlighted the considerable benefits that can be achieved by a locally systematised approach to service integration.

We have seen tragic results where responsibilities are not well co-ordinated and systems don’t work effectively, in situations such as protection from family violence and the quality of our water supply.

The challenges facing our most vulnerable children and families are multi-faceted and cross many agencies so singular solutions deliver only partial solutions, and don’t meet expectations.  This point was made quite strongly by the expert review of child protection1.  For example, while the loss of documents by agencies is a key concern for those that use social services, departments do not keep records that allow this situation to be monitored, and therefore initiate actions that might reduce the frustrations and stress it causes.  Similarly, the Ombudsman’s inquiry2 into prisoners at risk of suicide found no proper record-keeping of treatments, judging that this

“…amounted to cruel, inhuman or degrading treatment or punishment for the purpose of Article 16 of the Convention against Torture”.  

The 2017 review by the Children’s Commissioner into secure institutions now operated by the Ministry for Vulnerable Children Oranga Tamariki found that even now the seven institutions had little in the way of any common strategy for improvement, with limited commitment to improve practices and an absence of system leadership.

We cannot foresee all the important consequences of policy initiatives, yet a growing range of social services provision involves frequent long-term interactions with the same people.  This requires a deeper foundation in evidence and more adaptive organisational forms than those that coped with the baby boomer generation and their families. Recent learning about social services, stimulated by the work of the Productivity Commission3, recognises that making service delivery effective needs to be an integral part of policy setting.  Solutions controlled from the centre cannot manage the diversity of need and circumstance of the society we have become, yet reducing the autonomy of frontline staff has often been the first response in cases that have gone wrong.

How to meet the needs of an increasingly complex society
Our social sector is hard-pressed to provide effective social services to a New Zealand society that has become more complex, and where families and communities are less and less homogeneous in nature.  Government agencies take the lead in social services funding, delivery and monitoring, but have yet to develop the capacity for responsiveness that reflects the needs of today’s society.

A genuine recognition of the complexity of citizens and of the uncertain effectiveness of most service provision would ensure that performance failures are monitored and then influence continuous improvement. These processes rarely happen.

Commissioning agencies have concentrated on low-trust, short-term contracts with service providers. These incur high compliance costs on both parties. There is also an unreasonable expectation that high-trust long-term relationships between the service provider and their “clients” will result. Performance is measured by transactions rather than transformation, yet transformation is what is needed.

We do not know enough about how effective current programmes are, although this situation is beginning to change.  In the past, insufficient priority has been given to capturing the knowledge gained by practitioners in the field, either in public services or NGOs.  Successive governments have not found long-term solutions nor contained concerning trends in family and child protection, youth mental health, violence and housing. The term “wicked” has become a favoured label, and perhaps an excuse for policy experts and social scientists to use for issues which defy tools of analysis.

Inflexibility and risk aversion in our public services
The public-sector reforms of the 1980s provided a much-needed lift in the integrity of the public finance system and the management of public assets, made it possible to define more explicitly (and often limit) the role of public service agencies, and required Ministers to be clear about their expectations. The reforms also engineered opportunity for innovation and flexibility, although after just one decade we saw this counterbalanced by a heightened political aversion to operational risk-taking.

The introduction into the Cabinet manual4 of the so-called “no surprises” principle encapsulates this unfortunate shift well.  In the social services sector where there are so many transactions to oversee, many of which will fail to meet expectations, this has resulted in Ministers and their departments putting in place internal limits on departmental transaction risk.

At the same time there has been a down-playing of the external risks and costs faced by citizens, forbidding of advocacy by funded community organisations, limits placed on autonomy at an operational level, and minimisation of any evaluation likely to reach the public domain.

The ways that citizens can hold government to account for the social services they receive are quite limited when compared with medical care, policing or education. The performance management regime for public administration has evolved with mixed effects for social services. There is a strong degree of risk aversion at administrative and political levels, stifling the innovation that is more easily seen in sectors where there is a clearer path for citizens to hold government agencies responsible.

Inadequate use of available evidence
Social programmes are seldom regularly evaluated in New Zealand. For many services, we are not even able to determine the true level of demand. Without reliable evidence, the effectiveness and efficacy of any social services programme cannot be assumed to be very high. An incomplete framing in the past of problems (e.g. family violence, child abuse, and poverty) can lead to excessive trust in partial solutions. There is a bias towards the short-term and forgetting our past, rather than making the most of what we can learn from it.

There are many ways to gather information through relatively low-cost processes[4] but these are not regularly adopted, perhaps because of an aversion to explaining service deficiencies or a lack of quantitative skills. Usually, any information that provides valuable evidence is not strong in all respects.  If we are not aware of deficiencies, there is a risk that new data sources may constrain defining questions and the framing of social problems and solutions.  New data can bring richness to the analytical base – but we will never have sufficient information to fully shape programmes, their assessment and monitoring, or the form of the wider social services system and how the many roles within it fit together.

The generalisability of evidence is limited by the natural variation of citizens in ways which are not measured. Individual variability cannot be removed by any process, and always needs to be accounted for. Although we know little about the effectiveness of most programmes, that uncertainty is rarely acknowledged as they are operationalised – for example in the rules staff are expected to follow or the autonomy they have to do the right thing.

The pathway ahead
New information sources, leadership in connecting data, enhanced analytical competence and strengthened basic numeracy, and a strong framework for making quality transparent are now all vital. Putting these components in place needs to be anchored around recognising and understanding how they contribute to confidence in policy choices. Without this, resulting services will have little basis for understanding the context in which they operate, and we will not achieve the full benefits that each of these vital initiatives could bring.

Notes:

1. Highlighted in the Expert Panel Final Report: Investing in New Zealand’s Children and their Families

2. Ombudsman 1 March 2017: “Care and management for prisoners considered to be at risk of suicide and self-harm: observations and findings from OPCAT inspectors”

In April 2016, we requested the following information on tie-down beds from Corrections National Office;

  1. Which sites have tie-down beds?
  2. Which sites have used the tie-down beds between 1 April 2013 and 12 April 2016?
  3. On how many occasions have they been used?
  4. What was the duration of each tie-down episode?
  5. How many prisoners have been secured on tie-down beds during this period?

The Department informed us there is no central recording system for documenting tie-down bed use and that individual prisons do not record the information in logbooks

3. NZ Productivity Commission 2015 More Effective Social Services”

4. Cabinet Manual section 3.16:   The style of the relationship and frequency of contact between Minister and department will develop according to the Minister’s personal preference. The following guidance may be helpful.

a      In their relationship with Ministers, officials should be guided by a “no surprises” principle. They should inform Ministers promptly of matters of significance within their portfolio responsibilities, particularly where these matters may be controversial or may become the subject of public debate.

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