The Office for Public Management’s blog reminds of of the new Prime Minister’s comments about personal budgets in the debates. Cameron drew upon his own experience of caring for his disabled son and the huge administrative burden trying to individualise care can place on families. Question is whether his own experience and desire to make it easier for carers to get personalised budgets and the kind of care they want will really count for much… Something to think about.

Which leads me to this interesting post I found on New Phlianthropy Capital from Craig Dearden-Phillips. (Straight copying and pasting, giving credit to the author of course, is ok right? -Reminds me, found a previous blog post of mine on a blog called ‘About Children’ http://mom-aboutchildren.blogspot.com/2009/11/lesbian-parent-hoo-ha.html with no real credit nor explanation as to why it was there…)

Is ‘personalisation’ a good idea or a recipe for trouble?

This guest blog comes from Craig Dearden-Phillips MBE, a social entrepreneur and founder of Speaking Up, a charity that supports and empowers people with learning difficulties, disabilities and mental health problems to have a voice that counts. In this post he gives his views on ‘personalisation’ and what it means for charities.

`Personalisation’—where people are allocated their own personal budget to spend on the public services of their choice—is a hot topic among the UK’s think-tanks at the moment. But what’s driving it? What are its possibilities and pitfalls? And what does it mean for charities?

Personalisation hit the UK in the 2000s , driven almost single-handedly by the philosopher and social entrepreneur Simon Duffy and his pressure-group `In Control’. Duffy persuaded the UK Department of Health to try personal budgets in social care for older people and those with learning and physical disabilities, as an alternative to direct state provision.

Duffy’s argument was simple: The UK spends £20 billion (30 billions US dollars) on people who need help to live independently, 40% of which is tied up in `transaction costs’—bureaucracy in other words. Added to this was the fact that outcomes for these people were, at best, mediocre. So, Duffy argued, why not move to a system which cuts out the middle-man, costs less and results in greater user satisfaction? Sceptical of Duffy’s claims, the UK Department of Health ran pilots in 2006-08 which proved Duffy to be right—now 30,000 UK citizens are in receipt of a personal budget.

Progress by 2010, however, has been slower than anticipated. The local authorities that control funding for individuals have taken a long time to reboot their systems to allow people to get their money out. There have been wide variations in the rate of roll-out, suggesting that in many areas the local authorities don’t actually really buy into the policy—not a huge surprise as evidence shows that once people get their hands on a personal budget they often stop buying services from the state!

But this may soon change. Up till now, growth in UK public spending has meant that life has been able to carry on undisturbed in Britain’s sclerotic public sector. Soon, however, the taps will be turned off—creating a huge driver for cost reduction. As a low-cost alternative to traditionally provided public services, personal budgets suddenly make a lot more sense.

Personalisation is, of course, about more than budgets. It is also about creating a more customized or ‘personalised’ version of public services. At the moment, if you’re unlucky enough to rely heavily on public services in the UK, you will find that they are a bit like the first of Henry Ford’s motor cars: You can have whatever colour you like—as long as it is black! In an age when we have become used to sitting by a mouse and tailoring our experience as a traveler or purchaser, the public services experience feels Neolithic.

The biggest advances towards something resembling a normal customer experience have come from Conservative councils such as Barnet. Also known as `Easy Council’, following its adoption of the model of customer service showcased by the airline easyJet, the basic council service is free—but can be augmented or made quicker by customers who are willing to pay a bit more. This keeps the council’s own service cheap and enables any `extras’ to be funded by the citizen. While criticised in some quarters, ‘Easy Council’ is highly popular with its citizens and other UK councils are adopting the model.

So what does personalisation mean for charities? One clear change is that they will increasingly need to reach out directly to users, rather than upward towards the public bodies commissioning services on users’ behalf. What users say and think will have to be taken seriously lest they do what they haven’t yet had the opportunity to do—vote with their feet.

This can only be healthy. The problem with charities in the UK so far has been that, in the final analysis, they have only needed to impress the people giving them funding —either the public or public sector commissioners. Tugging on the heartstrings has tended to be just as effective as data, even with sophisticated investors. But as personal budgets take hold, we will get a much better idea of the impact of certain types of charities without the need for complicated impact-assessment tools—you will just need to observe the traffic of users between the various charities. For social care charities, this will be no bad thing.

Are there any drawbacks with personalisation? Undoubtedly, yes. One obvious one is that by individualising budgets, it is very easy to reach a position where popular services are quickly rendered financially unviable by the withdrawal of just a small number of clients. This has reportedly happened in a number of locations across the UK. Finding ways to enable users of personal budgets to `club together’ their funding to maintain or create new collective provision have not yet been found.

Another limitation is around economies of scale. Big services, while often low quality, are affordable and keep people safe and occupied, often with their peers in a setting that they are familiar with. Breaking down the budget for that service often means the individual can afford a lot less out there in the marketplace, leaving them without a service for at least part of the time.

A final limiter concerns the practicalities of personal budgets. A person with complex learning and physical disabilities will often command a personal budget in excess of £150,000 a year (250,000 US dollars). Managing this funding and all the risks incumbent in running what is, in effect, a small business, will challenge even the most capable and committed families. When a family has neither the time, ability nor inclination to do this, personal budgets look like a recipe for trouble.

However I am, after 20 years of my life working in charities alongside disabled people, personally very positive about personalisation. While it isn’t a perfect solution—and there isn’t one—it is preferable to both the waste of money and potential of a system in which the state both controls and consumes the funding intended to improve the lives of our citizens.

Read more about the author at craigdeardenphillips.com and follow his blognakedentrepreneur.blogspot.com

This is Professor Alison Wolf, potentially one of my tutors next year, talking about her latest monograph An Adult Approach to Further Education. From a personal point of view, it’s nice to see someone you might be studying under on YouTube (even if the camera keeps annoyingly zooming in and out). But also, for me, it’s good to have someone as senior in this field articulate what I always just felt was going wrong with further education.

For most of the summer holidays when I was an undergraduate I worked in enrolment in a further education college. The college offered a wide variety of courses, from BTECs to Foundation degrees, CIM courses, A levels, Skills for Life, then, yes, those things Wolf talks about like Train2Gain… Equally, at the college there was a diverse range of students. Not diverse, however, in the way that whatever class you walked into would be composed of students of every hue, faith, class, income, etc found in London, but rather simply the range of students reflected the range of courses. Indeed, the profile of a student attending any particular class was often so uniform that within about 10 seconds of a student coming up to my desk I would usually have a very good idea of what course they were doing. Middle class with a designer handbag? most often CIM paid for by employer; Somali, with kids in tow? entry level ESOL; Indian accent? then a postgraduate diploma in hospitality management; Chinese/Vietnamese? overseas fees for English or A Levels; Polish guy? evening ESOL; Polish girl? AAT or dental hygine; young black woman? NVQ hairdressing; sixteen year old girl? BTEC performing arts or hair & beauty; sixteen year old boy? BTEC public services or sports science. Getting in to the habit of sterotyping students, and very often down strong racial and gender lines, is not really something to boast about, but it’s quite easy to do when the pattern of students is so consistent.

What I think this really reflects, though, is how little choice there is in further education. How your income, socio-economic status, and, although more indirectly, ethnicity too, dictates what you study. Sure, the make-up of students in a class is going to be somewhat reflective of the type of funding available. Higher education, you have to pay for yourself, either with a student loan or not, so on the foundation degrees you’d tend not to find students on Income Support. Professional courses tended to be paid for directly by employers, hence most students would be in full-time, professional employment. A-Levels, in the day there’d mostly be 16-18 year olds; in the evening the older students who’d stumped up the cash (most often doing Chemistry in the hope of getting into med school…). For those on lower incomes and on benefits there were plenty of courses they could attend free of charge, except for a negligible enrolment fee. However, even though perhaps the majority of students enrolling were students going onto these vocational courses, I’d venture that this was the sector with the least amount of choice.

To put it crassly, the impression I gained was this: If you were unemployed, with few qualifications and in receipt of JSA you enrolled on a course. It had to be under 16 hours a week of course, else your JSA payments could be stopped. The subject you studied didn’t matter a great deal, I don’ t think. For the likelihood of you going into employment in a sector relating to your qualification, appeared to my perspective – and my very unimformed, onesided perspective I have to say – minimal. The amount of people taking a nail art course, for instance, surely didn’t seem to make any sense to the number of beauty salons/nail bars out there or out there and in need of skilled staff. One could berate the government from a more ideological perspective for their apparent notion that the economy can be planned though providing certain types of education. But when the delivery end of this is the production of a glut of manicurists the notion seems more pitiful. And evidence that will perhaps stand up to more scruitny, or at least be considered evidence rather than my prejudice towards nail art technicians, is the serial use of these courses. By that I mean students who repeatedly enrol on such courses, because, one speculates A) either the courses are not fit for purpose and do not make students more employable, or,B) it’s quite a laugh doing hair and beauty courses for a few hours a week for free.

I will explore that rather right-wing, knee-jerk answer B I gave another time. Although I do have to say that is at least the impression gained from my experience; that the nearest thing to a classic adult education service, where you can go to learn a skill for personal interest is found on these kind of courses. I should also add though that it’s not the quality of these courses I’m mocking either, for I have seem them produce quality results too: students winning awards, and getting decent, related jobs. That they appear to be the only option for education for many people on the dole, I do have reservations about though. Seeing a student’s enrolment history over the last few years consisting something of a childcare qualification, then Swedish massage, then nail art, then airline ticketing, all whilst on Job Seekers Allowance, makes you wonder. Is the provision of niche vocational courses the answer to unemployment? Do such qualifications make someone more employable? Do these people want to be studying these courses?

Trying to sound like a social scientist I did the “pah, correlation isn’t causation. There’s a whole host of other factors, indeed some that may themselves be related to inequalities in income, that could be responsible for the lower ranked workers’ health…” thing.

Well later on in the book the authors address my concerns, with macaques. By controlling for other factors (like diet and living conditions, which you can’t really do with people) and manipulating hierarchies, one can observe the effect of status on the macaques’ health.

See:

“Sometimes associations which are only observed among human beings can be shown to be causal in animal experiments. For instance,  studies of civil servants show cardiovascular health declines with declining social status. But how can we tell whether the damage is caused by low social status rather than poorer material conditions? Experiments with macaque monkeys make the answer clear. Macaques form status hierarchies but with captive colonies it is possible to ensure that all animals live in the same material conditions: they are given the same diets and live in the same compounds. In addition, it is possible to manipulate social status by moving animals between groups. If you take low-status animals from different groups and house them together, some have to become high-status. Similarly, if you put high-status animals together some will become low-status. Animals which move down in these conditions have been found to have a rapid build-up of atherosclerosis in their arteries. Similar experiments also suggest a causal relationship between low social status and the accumulation of abdominal fat. [Also as the authors previously outlined, another experiment] showed that when cocaine was made available to monkeys in these conditions it was was taken more by low social status animals – as if to offset their lower dopamine activity.”

Hmm compelling stuff. Inequality shown to be a direct causal factor of obesity, heart disease and cocaine/drug use…

One quibble is that the mentoring is largely done virtually, through email. Undoubtedly this strategy does help enormously to recruit and retain the professionals in law, architecture, medicine that the organisation hopes to pair up with sixth formers. It is quite a different thing, though, from more famous youth mentor programmes like Big Brothers Big Sisters in America.

Big Brothers Big Sisters or other similar programmes don’t just allow the fostering of a stronger relationship than email correspondence can achieve, they simply have a more far-reaching ambition. It’s not just about getting grades and getting into university, but preventing drug and alcohol abuse and truancy. Moreover, they start  younger than 16.

This is what baffled me most about the Social Mobility Foundation. Their target group is 16 year olds, doing A levels, predicted decent grades, but on EMA. Frankly, these kids are doing fine. Maybe a bit of careers advice wouldn’t go amiss but they’ve made it this far already…

To really tackle social mobility you have to start early. Maybe the Social Mobility Foundation ought to address the children who fail to reach basic GCSE standards. Nearly half of pupils in London fail to achieve 5 GCSEs (including English and Maths) at least grade C. Thousands have a reading age several years lower than their actual age. To really address educational achievement and social mobility you have to start early; certainly earlier than A Level, and perhaps only significant impact can be achieved before secondary school…

I’m reminded of a graph in Demos’ Building Character report, taken from work by Leon Feinstein. The graph illustrates average rank of test scores of children at 22 months, then 40, 60 and 120 months, split in to those with parents of those of high and low socio-economic status. What’s most troubling from the graph is where the children tested at pre-school end up age 12 seems to be determined most by their parents socio-economic status, certainly more than would would be seen to be their innate ability/nurture as an infant (from when tested at just 22 months). The highest performing kids at 22 months with wealthier parents maintained their position of high academic achievers. Whilst those who performed equally well but came from more disadvantaged households plummeted drastically around the time of starting primary school, so much so that by the age of 12 they performed far below their more privileged peers who had begun with a low test score at 22 months.

I must find a way of sticking the graph on here. It can be accessed in the report Very Early Evidence, on page 29. Much better in graphic form than my waffling.

But clearly one can deduce that socio-economic status has a large impact on educational achievement. Tackling this right from the very early years is surely the only way to engender social mobility.

And maybe a way of tackling that, apart from, or in addition to, improving education from early years through secondary, employment opportunities for parents, and the social conditions which are detrimental to social mobility could be through mentors.

The impact inequality has on our health, and particularly mental health too, is quite worrying. For instance, it is widely accepted that stress plays a large part in the development of many chronic diseases. But forget about some stressed out careerwoman with pointy 80s shoulder pads keeling over of a heart attack.It’s those at the lower end of the social hierachy that suffer more stress-related ill health.

A longitudinal study initiated in 1967, the Whitehall study, surveyed the health and mortality of workers across the hierarchy of the civil service. Those in the lowest grade had a death rate x3 higher than those of the highest grades; lower status jobs were also associated with heat disease, some cancers, depression, chronic lung disease etc. “And of course factoes such as absolute poverty and unemployment cannot explain the findings, because everybody in these studies was in paid employment” say Pickett and Wilkinson. Granted, but factors associated with a lower income like poorer housing and diet can surely account for the lower ranking civil servants’ health…

The authors annoy me slightly by concluding almost every topic with “there is too much of a correlation to be down to chance. We must be right. Shut up.” It’s not really that tone. I do largely accept their theis; there are times, like with the above study, where they fail to mention things like how the diet and lifestyle of the messengers and doorkeepers of Whitehall may have a bearing on their developing heart disease, and go straight to concluding inequality is the major factor.

However, one area of health where there seems to be growing evidence that it is not just lifestyle factors associated with lower social class that play a large part is obesity. In the developed world, the poorer are more likely to be fatter. Obesity is obviously linked to poor diet, availability of energy-dense food/ fast food/ sugar, fat, high-fructose corn syryp, lack of exercise. But calorie intake and exercise can only explain so much. Stress plays a large part too. Stressed people comfort eat, and not only that but being stressed makes the body store fat differently and makes it harder to shift.

This brings me on to the Thrify Phenotype. It’s a cute name, but not too sweet a hypothesis. It has been shown that there is a genetic factor in obesity, and this hypothesis goes some way in explaining why if obesity is genetic it has only erupted recently in human history. The thrifty phenotype is a clever adaption for a tough hunter-gatherer existance, but bad news in the 21st century developed world. The hypothesis goes that when a pregnant woman is stressed, the development of the foetus is modified to prepare for life in a stressful, food-scarce envionment. Thrifty phenotype babies have a lower birthweight and lower metabolic rate. In other words,stress produces children “designed” to need less food, although unfortunately they’re born into a world where often the cheapest, most abundant food is the most calorific.

Firstly, it seems bizarre for proponents of marriage to make what they see as a sacred union more of a callous financial choice. Second, it is totally crazy given the economic mess we’re in that an incentive that would cost upward of £3.2 billion (the figure £3.2 billion ruminated in the summer, although The Spectator now cites a House of Lords debate which suggests it’d cost £4.9 billion a year). Spending so much is all the more foolish when the rewards marriage supposedly reaps in the form of kids’ better educational performance and decreased likelihood of taking drugs are a) in the future, and b) very difficult to calculate anyway. This leads me to my final point that the proposal is founded on the idiotic assumption that a wedding band on a finger makes a relationship good, and that it is this that causes children of said relationship to not do drugs, do better in school, not become dependent on benefits and be an all-round stalwart citizen.

Peter Hoskin for The Spectator is sceptical of the effect of  “deploying fiscal incentives to force something which should largely be a private decision, based on sappier motives such as love.” He later asks, in response to an avid marriage incentiviser, how many people would consider marrying, or not divorce as readily, for £20 a week and suggests the costly plan may only have a very slight social effect. Yet I think it’d be wrong to dimiss the effects that financial considerations can have on the decision to marry.

“I married for money” reads the headline of Eleanor Mills’ column in The Sunday Times today. She makes a good point. People do marry for money; not necessarilly for financial gain, but for considerations like pension entitlements. They also do not marry for financial concerns;  today the cost of “buying a house or having a child is the priority, with marriage seen as an aspirational extra, a great excuse to throw a party, not a necessity.”

Indeed, a couple can live together now as if they were married, without being married. They can be committed to each other, have children and be mortgaged to the hilt. Eleanor Mills claims getting married eventually made her feel more secure and settled. I will not suggest marriage does not have this affect on people. Yet there is no way of proving the hypothetical of how she may have felt several years on with her partner had they not married, the quality of their relationship and the quality of their relationship with their children.  It’d be safe to say that apart from a few legal benefits, the state of being married does very little to change the relationship of a couple than when they were not married but living together.

Supporters of marriage incentives can look to statistics which suggest marriage makes people better, but I can assure you the cause of the social problems they highlight are more complicated than whether mummy and daddy were married. One particularly irksome set of stats brought up to lambast lone parents, is a piece of research by YouGov which found:

children brought up in lone parent families are:

75% more likely to fail at school
70% more likely to be a drug addict
50% more likely to have an alcohol problem
35% more likely to experience unemployment / welfare dependency

This is what is used as ammunition in the arguement against lone parents and for marriage incentives. But correlation is not causation! Lone parents do not cause their children to fail at school, it is far more likely to be the case that a majority of lone parents are relatively less educated themselves and live in areas where the quality of schooling is poor. It is these variables that bear more on educational performance. It is also likely that not performing well at school and leaving without qualifications have a significant impact on the likelihood of becoming a lone parent. As multiple TV documentaries on teenage pregnancy attest, lone parenthood can be a conscious, assertive decision that some girls make in the wake of very limited prospects elsewhere. See also the Joseph Rowntree report on ‘Planned’ Teenage Pregnancy.

What is also wrong is equating children with unmarried parents with lone parents. Stats on lone parents do not then make such a compelling argument for marriage. They may instead make a more solid case for couples to raise children. And indeed, the added emotional support a partner can have for a parent should not be underestimated. But there are also many types of “lone parent”, from fortysometing singletons with adopted kids and widows, not all are the feckless kind who inhabit the set of Jeremy Kyle and marriage incentivists’ imaginations. Look in the differences in these lone parents, take into consideration poverty and the quality of schooling and housing, and I think you’d have a better idea of the cause of negative child outcomes.

Taking this into consideration, it should become clear that marriage is not a panacea. Marriage per se is not what matters, but strong relationships and financially stability – and these are the very factors that tend to precede marriage.

Why don’t we encourage this? Make it easier for couples to set up home, earn a decent living, and for young people to leave school with a sense of selfworth and job prospects. We’d be better off all round. Much better than providing a tax break to a dastardly philanderer, as Harriet Harman put it, on his third marriage whilst wife number one and two bringing up his kids are left out of pocket.

I remember taking note that there was a journalist from The Sunday Times behind me. Lo and behold in The Sunday Times that week: attention grabbing headline (albeit at the bottom of the page, somewhere in the middle of the paper), “Lesbian parents better at raising children“. Assemblage of bits on lesbian parents, gay adoption, a quote from Mary Cheney, that hadn’t found a home in the print of the Times yet, spun around a quote from Stephen Scott who was on the panel of the Building Character event.

Stephen Scott of the National Academy for Parenting Practitioners, which joint-hosted the event with Demos, did refer in passing to research that suggested lesbian parents were “better” than a man and a woman. Hmm, and then strangely that little juicy snippet was what was most discussed from the whole thing in the papers. Discussed by The Daily Mail and Jeremy Clarkson…

Thing is, Jeremy Clarkson’s column in The Sunday Times the next week pointed quite well to how silly it was to say that, definitively, lesbians make better parents. And (worryingly?) Clarkson was funnier than I thought he was (although still nowhere near properly funny, he was starting from a very low estimation). Similarly, a piece on the blog of the think tank Civitas questions what this research was. Civitas is a think tank that I don’t hold in very high esteem either, and amusingly all the quotes from “newspaper reports” were from that original Sunday Times article, so maybe it wasn’t as “widely reported” as Civitas insinuates. (Shame on me too for only scouring the pages of The Sunday Times for references to something I attended. At least by attending I know that Scott’s mention of lesbian parents was not in a speech *ahem, Civitas*).

Anyhow, it’s come to Clarkson and Civitas (god forbid) to asking what-the-hell-is-this-research?!?!? Shame on you, Mr. most-popular Sunday broadsheet, for such a cobbled-together article.

What I found on the NAPP website was “Evaluating the evidence: are lesbians better parents?“. This, quite rightly, tentatively concludes that:

“Although children with lesbian mothers, on average, do slightly (but significantly) better on some measures than children raised by opposite sex parents, a positive relationship with one’s father is also strongly associated with positive child outcomes… Research consistently and clearly suggests that regardless of parent gender and family structure, children who report a close and positive relationship with their mother and father are more likely to feel good about themselves and do better in school and later adulthood.” [italics in original]

The point about good parent-child relationships was the very point of the whole Building Character event where this recent lesbian parent hoo ha began. It was the point being made when this, rather distracting point, was thrown in: quality relationships matter more than family structure.

The research on lesbian parents, from what I have seen, does seem rather dubious though. I took a look at Golombok et al “Children with Lesbian Parents: A Community Study“, the first cited research in the above menioned NAPP review. Here I’d be inclined to agree with Jeremy Clarkson; “You can’t possibly draw any conclusions after testing 20 lesbians.” The sample was tiny. Not quite as tiny as 20, but a grand total of 39 lesbian-mother families.

As I, and Civitas (hmm), suspected it also appeared that the lesbian-mother families on average were of a higher socioeconomic status that the straight-mother families. The qualities of better parenting were defined as less use of smacking, greater frequency of imaginative play, etc. which also correlate well with middle-class families in general. Findings from elsewhere that daughters of lesbians are more likely to aspire to be a doctor or lawyer or “professions that were traditionally considered male” and children brought up in an all-female household are “more confident in championing social justice” (see that first Sunday Times article), could also readily be attributed to these being more middle-class traits. It does not necessarilly follow that lesbian parents are a causal factor of this “better” parenting. A common sense answer would be that lesbian parents are more likely to be middle-class and these determinants of better parenting are generally reflective of middle-class parenting. Girls from your average middle-class home want to be doctors and lawyers and were most likely not smacked either.

Elsewhere in that Sunday Times (15 Nov- I am so slow in writing stuff. Have a decent memory though) were graphs of the number of women compared to men entering the professions across the last 3-4 decades – they all steadily climbed upward. Annoyingly the graphs aren’t on the web version, but I can tell you that last year 60% of new solicitors were women. But I digress…

Yes, so this study by Golombok et al did not account for socio-economic status bearing an infuence on the results. They got some stats on the socio-economic make up of the sample, but then dismissed its importance. I think it’s important. The covariates the study accounts for are instead just the child’s age and the number of children in the family. I’m not a social scientist (yet…) but I wouldn’t agree that “no group difference was found for social class”  when about 1/10 lesbian mothers had no qualifications compared to 1/4 straight mothers. Surely it may well be something like this that has the greater impact on parenting style and children’s aspirations?

Without good longitudinal studies of gay parenting, which also factors in variables of social class and education, and is done on a much larger scale than39, we shouldn’t be making any suggestions as to lesbians being “better parents.” And refraining from slipping a remark as Stephen Scott did at the Demos launch wouldn’t go a miss either…