Is there such a thing as Citizenship in relation to public services?

I attended a couple of seminars on health recently. Both acknowledged that there are massive problems with resourcing health care, whether nationally or globally. At both seminars, I asked how the speakers thought we might better engage as citizens with the questions of how we structure and finance our health system – and in neither case got an answer. A former colleague suggested to me that perhaps that is because my question has no answer. It would be a sad day for Citizenship if there is no answer to the question of how we the citizens can help decide what kind of health care system we want and are willing to pay for. This is especially so as, at the point of need, our desire for care is so urgent and critical that there is no way we would do anything other than argue that our need is absolute, and the health care system must do everything it can to provide for us. But hospitals and governments have budgets, and they must prioritise what they do in order to stay within budget. A debate about health care could easily set the young against the old, the chronically ill against the mainly healthy, smokers against non-smokers. And yet we all have to live – and eventually, die – in the same society.

One of my concerns is way in which much current government support of ‘engagement with public services’ consists of the ‘make your voice heard’ and ‘have your say’ messages which help establish a culture where the mark of success in civic engagement is having secured resources for one’s own cause, rather than having helped in a deliberative process that looks at how resources are raised and distributed. While I believe that it is extremely important to have some form of promotion of voice to enable those characteristically excluded from public space to feel confident in their own voice, the voice is only the beginning. How do we ensure that as well as owning our voices, we listen actively and consider the impacts of choices on our wider communities? Government, in its intentions to improve the delivery of public services and offer more choice casts us all as consumers, not citizens. Yet, voices from health care quietly assert the importance of Citizenship. Neil Churchill, Chief Executive of Asthma UK wrote recently in the ‘Healthy Futures’ pamphlet published by the Smith Institute:
‘Most people I meet are conscious of our duties as citizens towards the “public good” represented by the NHS and the claims of others on its resources. Good citizenship should be encouraged in healthcare and we need to engage patients in things they have in common, and not set them apart by arbitrary distinctions between different conditions.’

And Martin Dockrell, Director of Policy and Research at ASH, highlights an example where a campaign that took a citizenship model of social and economic inquiry was more effective than the traditional individualised messages of health promotion:

“Virtually the only youth tobacco campaign to make a significant impact on teen smoking did not even mention the health consequences, instead it focused on the behaviour of the industry and its role in child labour, environmental harm and marketing manipulation. In short, it engaged with young people’s sense of social justice.’

It is perhaps not surprising that these voices on the importance of Citizenship within the public service of health, come from the NGO community, which is perhaps more disposed to collective action. Nevertheless, they are important examples to us in theCitizenship community precisely because the main concern of these experts is better health, not the promotion of Citizenship learning, and yet they strongly make the case for the need for Citizenship thinking in health.

When I heard that Ade Sofola, the leader of the Youth Act project at the Citizenship Foundation, was going to take young people from Lewisham and Eltham away together on a Youth Act residential, it brought back sharp memories. I only need to hear those two London place names mentioned together and I’m back in 1993, when Lewisham, with a large black population, and Welling, largely white, and home to the BNP, collided. Eltham was where it happened.

I used to get off at the next bus-stop up from the one where Stephen Lawrence was killed, several times a week, to meet my boyfriend Tom. Tom had a knife held to his throat once at the cinema opposite that same bus-stop when we were doing nothing worse than walking down the road looking happy. I was thumped once in Blackheath for trying to stop some drunk men bullying a Chinese family. Although we felt we led sheltered lives, and it was nothing like as bad as the postcode warfare that blights the lives of so many young people today, like any teenagers, we were not entirely safe. But the last thing we were going to do was tell our parents or teachers. They’d have stopped us going out. We valued our freedom more than our safety. But when Stephen Lawrence died, and even more, when the police failed to find his killers, it changed our neck of South East London, and it changed all of us.

I would probably never have thought to join anti-racism societies at university had I not seen my stamping grounds turned into a battleground. When I saw certain political groups in the student union try to claim it as their issue as they went round the residences, recruiting supporters, I slammed the door in their face. It was my neighbourhood, our life, that they were using to score points with. I hadn’t been angry at the time, I didn’t even know how to talk about it with my own friends properly. It only made me angry afterwards that we had been so let down that people, young people, turned on each other in violence. Angry that we didn’t know who to believe or to trust. Angry that a young man had died on our streets and people I met claimed they knew who killed him, but would not name names.

We weren’t scared, we were too young to know what scared meant. We enjoyed the tactics. Meeting my boyfriend and his mates and mapping out which side streets we would use to avoid the gangs we had heard were over from Lewisham for the night. Discussing matter-of-factly with my best friend, who is mixed race, whether we would be safer walking together or separately. The weekend after the killing when I stood by the river, looking at the hill going up from Greenwich towards Eltham, and seeing unexplained fires I had a feeling of threat – but also the exhilaration of not being dead. Then the rumours. Being told by a man we met in the pub that it wasn’t a racist killing, ‘just’ gang warfare. Then as we waited by a bus-stop at the end of the night, seeing that same man face a bus, scratch his armpits and dance from foot to foot, making monkey noises, directed at a black man inside the bus. Then he had gone. It was sickening. A racist telling me that something was not a racist killing.

I believe that we all have the seeds of violence inside us, and that we have the tools in ourselves to make sure that those seeds do not grow. I know that those of us who were in our late teens in South East London in 1992 will not forget what happened. I think if there had been a project like Youth Act there, then, we would have had more of a means not only to make our streets safer, but to talk to each other, and to the police, and the MP, and everybody. We could have maybe seen for ourselves if we thought the police were institutionally racist. Perhaps people would have felt safer in speaking to those police about what the gangs were doing, or we might have known if they actually were on the streets, or were rumours by people who like to frighten other people. Perhaps we would have let our parents know that we thought we might be in danger, but was there still some way we could go to hang out with our friends. Maybe we could not have saved Stephen Lawrence. But we owe it to the memory of every young person who has died in the battles on our streets to bring peace wherever we can.

This bill is going through its second reading in the House of Commons today. http://www.publications.parliament.uk/pa/cm200607/cmbills/035/2007035.pdf
I‘m in a shared ownership property, which means that the biggest financial commitment I have ever made is with an organisation that I find curious and baffling and to which I am intimately bound. The mysterious place they call ‘Head Office’ in which decisions about my domestic circumstances are made is completely unknown to me and yet every inch of my carpet is known to them. They are certainly autocratic and whimsical, often quiet and obscure, and may be relatively benevolent, but after four years of sharing a flat our hearts are still strangers to one another.

This bill appears to rebalance the situation towards the tenant. My reading of the bill is that it would require housing associations to produce a service agreement which would be approved by either the Housing Corporation or a tenants’ jury. An inspection of the housing association and whether or not it is living up to its service promise can be requested by the tenants association. If the housing association continually fails to deliver on its service, the Housing Corporation may ballot the tenants on whether the management should be transferred to another housing association.

I have encouraged the residents in my block to write to our MP to recommend she support this bill, but it belatedly occurred to me that I have no idea whether this would be a good thing or not. How can I find out? And how can I find a website that decodes parliamentary bills into plain English?

If you are also a tenant of a housing association these links might be useful:

The website of the housing association regulator:
http://www.housingcorp.gov.uk/index.php

If you want to contact your MP about the bill you can look them up on http://www.theyworkforyou.com/