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This week saw the appointment of a new minister for suicide prevention announced on world mental health day (BBC), and an article in The Guardian observing that mental health resources are woefully underfunded.

My thoughts first turned to the fact that the appointment of a minister to address the problem was reminiscent of New Labour’s previous attempts to address issues with the appointment of various czars, none of which were very successful (BBC).  Allied to the appointments were the inevitable plethora of new policies, many failing at the first hurdle. Nonetheless their longevity and to some extent durability lay in ministers’ and state agency managers’ egos, and inability to see beyond fantasy and media pleasing rhetoric. However, it would be disingenuous to fail to acknowledge that some policies and strategies are conceived and implemented with the best of intentions, both at the macro and micro.

The old saying that ‘no plan last[s] beyond the first encounter with the enemy’ (Hughes,  1993:14) probably explains why so many policies fail, not because the essence of the policy is wrong but because politicians and those in charge fail to take into account or to rationalise that at the very core of the policy intentions, lay people.  People are unpredictable, people do not conform to ideals or preconceived ideas and, yet policies are formulated to address ideal situations and an ideal homogenous population. No one member of the public is the same, whether they are a victim of crime, an offender, a person in need of medical care or mental health services, a worker, a student or a user of a service.  They can be one of these things or a combination of them, they are a product of so many differing socioeconomic influences that any one policy cannot ever hope to deal with the multitude of issues they bring.  People are both complex and complicated.  A plan or policy needs to be adapted and changed as it progresses, or it will inevitably fail.

That brings me very nicely to one of my favourite authors Michael Lipsky.  Lipsky presents those working at the coal face of public services as street-level bureaucrats.  Attempting to navigate policy and strategy implementation whilst dealing with predominately less than ideal clients.  Lipsky observes that in doing so the street-level bureaucrats are faced with a number of different issues:

1. Resources are chronically inadequate relative to the tasks workers are asked to perform.
2. The demand for services tends to increase to meet the supply.
3. Goal expectations for the agencies in which they work tend to be ambiguous, vague, or conflicting.
4. Performance oriented goal achievement tends to be difficult if not impossible to measure.
5. Clients are typically nonvoluntary; partly as a result, clients for the most part do not serve as primary bureaucratic reference groups.

(Lipsky 1983, 27:28)

Policies and strategies are difficult to implement, if they are formulated purely on ideals without ever having recourse to those, i.e. the street level bureaucrats, that are required to implement them, they will inevitably fail. If plans rarely survive the first contact, then they need to be adapted or ditched, those best placed to advise on changes are of course those at the coal face.  Herein lies the rub, politicians and managers do not like to be told their policy is failing or that it will not work in the first place. They inevitably place the failure of policies, or reluctance to implement them, on those at the coal face with little or no knowledge of the issues that are encountered. The raising of such issues are simply seen as an excuse, laziness or a reluctance to change.  More often than not, the opposite is true, street level bureaucrats want change, but for the better not for the sake of it or to be seen to be doing something.

It is difficult to see how the appointment of a new czar will make a difference to suicide rates without fundamental changes in the way that policies and strategies are conceived.  Those thinking of writing policy whether at the macro or micro, would do well to get a hold of Lipsky’s book and to reimagine the ‘real’ world.

Lipsky, M (1983) Street-Level Bureaucracy: dilemmas of the individual in public services, New York: Russell Foundation.

Hughes, D (ed) (1993) Moltke on the Art of War: Selected Writings, Random House, (ebook)