A few words on Chronic Fatigue Awareness Day

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A couple of months ago I stumbled across May 12th being the date for Chronic Fatigue Awareness Day, and that for 2015 there would be another #May12BlogBomb event. It was a pleasant surprise, as there’s little doubt in my mind that chronic fatigue is a condition which needs far greater public awareness. It also seemed a good occasion to dust off the quill (or keyboard, but that doesn’t sound quite so romantic does it?) and write again, which I’ve not done much of since having chronic fatigue. I’ve still got this old blog, which I’ve not used for ages and which has a title that isn’t even vaguely relevant anymore, but it will certainly do. I figure it’s a good opportunity to add a little more noise to the #May12BlogBomb.

 

I’ve spent my short career thus far working in mental health and wellbeing, and I’ve seen that chronic fatigue is afflicted by many of the same problems as mental health issues are. To name a few; a lack of understanding, stigma, and the mainstream health system being poorly equipped to deal with it. I’ve seen awareness around mental health issues grow considerably over the last decade, and I’ve also seen how powerful it’s been when people share their stories. That’s all I really have to offer this year for chronic fatigue awareness day, even it feels rather self-indulgent. However, if it creates a little bit more understanding somewhere then it’s got to be worthwhile.

 

 

Triggers

This particular story starts with a young man living in London who attempts to fit a two days’ worth of work (sometimes three) into one, cycles to work in the winter rain to save money and generally considers any physical ailments to be irritating obstacles preventing him from getting to where his mind thinks he ought to be. He finds life pretty stressful and difficult – more so than he used to find it.

 

During January last year, which is pretty much happy season for viruses, he finds himself unwell with what seems to be a generic flu/cold-like thing. Much to his irritation, he gets over one virus, and then shortly after another one arrives. This carries on for a while, until eventually the viral symptoms have gone, and yet there remains a peculiar feeling of exhaustion – as though he’s not slept at all, has severe jetlag and has just run ten miles.

 

The young man is confused. He returns to work. He gets home, immediately falls asleep and wakes up later on that evening wondering what happened. He repeats this for a few days before resigning to more time off of work and seeing the GP, who promptly diagnoses postviral fatigue. It should pass in a couple of weeks says the GP. The young man thinks that this is an unacceptably long time…

 

Several weeks pass and there is little improvement. He decides that if he changes his job that should fix things. He goes to interviews and then has to rest for several days afterwards. He then decides it must be the house, so he goes flat hunting and the consequences are very similar. He determines that it’s time to turn to Doctor Google. He follows the virtual trail of breadcrumbs and they lead him to chronic fatigue syndrome/ME. The thought terrifies him, as do the horribly low recovery rates, but each day makes this realisation seem clearer. And he’s getting worse, not better.

 

At this point he gets fortunate – very fortunate. It turns out a friend of the family works at a clinic set up specifically to help people with chronic fatigue and fibromyalgia. She explains what’s happening to his body, tells him what to do now and reassures him that she’ll help him get over this.

 

A few weeks later and he’s packed up most of his life in London and moved back in with his somewhat surprised but supportive parents to (attempt to) get better.

 

 

Recovery

I remember very little of my first month back living with my parents, but they tell me that our conversations rarely consisted of more than a few words, and I was asleep most of the time. I’m quite sure that the person happiest about the situation was the cat, who now had a full-time sleeping companion.

 

I do remember feeling relieved. My body felt so exhausted and was craving rest, which was much easier to do now I was no longer living in London. It was not a comfortable position to be in however, physically or psychologically. I felt mentally foggy, physically wiped out and everything ached – this was essentially the case all of the time unless I was completely distracted (thank goodness for Sky Sports). Weeks would pass with me hardly being there, and day to day reality could be pretty bleak. I was very restricted in how much I was able to engage – contributing to dinner for example could be considered a grand achievement.

 

The psychological adjustment to begin with was chastening and there was an element of grief. I had to let go of my job, independence and acknowledge that any goals I had at the time (finding a cool flat, the perfect job, a nice girl) would be postponed indefinitely. I cancelled summer plans – a trip to Scotland, a cycling holiday tracking the Tour De France and hated the feeling of letting people down. Amusingly, the thing I held onto the longest was the Oxfam Trailwalker; a 100k charity walk that has to be completed within 48 hours. I have no idea what I was thinking in still aiming to complete it and my parents mocked me repeatedly for it. Bear in mind I needed a lie down after a walk down the road to Tesco and back… I guess you have to let go of things gradually.

 

It didn’t take long though for things to start picking up. I began working with a nutritionist, the chronic fatigue health practitioner I mentioned earlier, and added relaxation practices such as meditation and yoga to my daily routine. The people helping me were, and still are, amazing – I’d have been lost without them. I struck gold with my GP too, who started by giving me the most enormous list of blood tests to check whether there could be another cause. For those who aren’t aware, chronic fatigue is a diagnosis of elimination.

 

There was definite improvement. My folks said that when they heard me playing the guitar for the first time since I moved in they knew I was feeling better. Indeed, in time I found myself feeling better in myself than I had done in quite some time. I’d been rushing around for the last five years, and the change of pace was actually rather welcome. I guess I found peace with my situation, which is rather more pleasant than fighting it. I also learned a lot during that time, but more on that later.

 

I was blown away by the support from friends and family, who showed so much understanding. Some in particular took the time out to lift my spirits almost every day, and I’m so grateful. My day to day life was limited in many ways, but I still had those relationships with people – and that’s by far the richest thing. I was aware that some people were quite sceptical about the condition, but to be honest I’ve never gotten hung up on that. It’s a confusing condition to live with, and I’d imagine much more so looking from the outside in.

 

The last twelve months have definitely seen my health going in the right direction, although it’s been up and down the whole way. The peaks and troughs are less severe now, and the troughs don’t seem so deep or difficult to clamber out of. Different parts of my system have recovered at different speeds. For example my general energy and immune system are pretty good nowadays, but I can’t sustain mental activity (like this!) for too long before I begin to feel foggy and my eyes start struggling.

 

Each month that passes I feel like I can do more. I’m now able to have a pretty lively social life, I go dancing, I can work a little, I drive to visit friends/family around the country and I’m talking to a couple of places about volunteering. The warmer weather’s even got me thinking about riding my bike again for the first time in eighteen months. All of this really feels magic, and I don’t take any of it for granted in the way I once did. I still have probably one or two ‘bad’ days a week, where I can do little more than just rest and wait for my energy to return, but this is in stark contrast to last year when the bad days were the norm, rather than the exception.

 

I wouldn’t say getting over chronic fatigue has ever felt easy, but it gets easier. It’s still frustrating to cancel arrangements and to miss opportunities, or to have to wait to do what you’d really like to do because you know your health isn’t up to it yet. You yearn to live a more active, normal life like many of the people around you. Most of the time though the negativity is outweighed by the knowledge that I’m improving, and by how wonderful it feels every time that I get out and spend time with people. I’ve always believed I’ll get better eventually, and the question of ‘when’ has faded away.

 

 

Lessons

Chronic fatigue has been a brilliant, if sometimes brutal, teacher. Often the most valuable lessons are learnt in the hardest way, and I’m sure that the difficulties of the last year will be far outweighed by what they’ve taught me about how to live for many years to come. I’m thankful for this. I’d say that I’m now more self-aware, patient, tuned into the needs of my body and more accepting of how things play out. I’ve discovered that even on the extreme days when I’m so exhausted that leaving the sofa is a daunting expedition into the unknown, it’s still possible to feel a very profound sense of joy – perhaps in a song, or listening to the rain, or in a short moment of connection with someone. You can take strength from the fact that you didn’t shy away from the situation; you at least showed up.

 

Most of the learning has been psychological and spiritual. If getting into a chronic fatigue state is a consequence of our actions and behaviour, and those actions and behaviours results from our psychology (largely unconscious) then it follows that this is one of the keys to recovery. In my case, it was the drive to achieve and help others that burned me out. These aren’t necessarily bad, but they need to be tempered. Going a little further, many of our more harmful behaviours are triggered by fears buried deep in our unconscious. Bringing those up and working through them is not only valuable for recovery, but also for other areas of our lives. There are no dark corners in my mind anymore that I’m scared to explore, and I feel freer.

 

In addition, a lot of us are dreadful at paying attention to our bodies – I sure was. We’re stuck in our heads, and we listen to our minds at the almost total occlusion of the needs of our bodies. I can count on the fingers of one hand the people I know who really give their bodies a chance to rest when they’re unwell.

 

Spiritual practice is wonderful for various reasons. It helps keep us calm (stress is the enemy of recovery), aids us in tuning in to ourselves, and increases our sense of wellbeing – not least because I laugh at myself almost every time I attempt yoga. I have the flexibility of a door.

 

I believe we’d be much happier if we had a stronger spiritual, inner component to our lives. Generally, we’re so locked up in pursuing external goals that this gets neglected.

 

 

Final thoughts…

My mind is beginning to resemble what I imagine Homer Simpson’s must be like, so I’m going to tie this up.

 

Everyone’s experience of chronic fatigue differs in its symptoms, duration and severity. My experience is definitely on the more mild side and that, for me, is very saddening. I was very lucky in catching it early, and in the support/advice that was given to me. I’m lucky to even be able to write this.

 

For some, getting out of bed and dressing themselves is a good day. I rarely hear recovery stories shorter than about three or four years. I hear many stories where people have had this for decades and have no hope of getting better. I want to give all of those people a hug. It’s remarkably prevalent (estimated to affect over one million Americans), and I can’t overstate the extent that chronic fatigue can affect someone’s life – and the knock-on effect it has on those around them. Yet, it hardly gets talked about and most countries’ medical systems are in denial about there even being a physical component to it. This can’t change soon enough, and anyone with chronic fatigue can tell you what nonsense that is.

 

What’s stood out to me is how common it is in my generation and age group. It makes you think – why are so many of us burning out in our twenties? I wrote down some ideas on this a while ago, questioning whether this is largely a symptom of modern lifestyles. Research shows that these days we sleep more poorly than before – 42% of us rely on sleeping pills, we sleep on average 1.5 hours less a night than at the turn of 1900, and even when we are asleep we are too wired to enter deep REM sleep. We also work longer hours, are under more stress and consume more caffeine, all of which keeps us in a fight or flight state. Stress-related illnesses are on the rise, as are obesity and mental health issues. Our bodies collectively are creaking under the relentless demands of modern society. I’d posit that those in their 20s, attempting to carve out careers, pay off enormous debts, buy houses and go out partying several nights a week are getting hit hardest by this, but no one is immune. How many of you feel like you need a rest from life?

 

I’ve just ambushed you there with a depressing couple of paragraphs.

 

Sorry.

 

However, the reality of chronic fatigue is not cheery, and we shouldn’t shy away from that. Nor should we bury the positive messages that emerge from it. Recovery is possible – I’ve seen the evidence of that in a number of people. And if not recovery, then it can be managed. Gradually, research is shedding light on likely causes such as reduced mitochondrial activity and immune dysfunction. We’re finding out which alternative therapies work, how to plan our nutritional and what the best psychological strategies are. Plus, the way I’ve seen it give people courage, self-understanding and appreciation of life is quite remarkable.

 

I believe that we’ll get better at dealing with chronic fatigue, just as we have with other health conditions that were once much more stigmatised than they are today – like cancer or mental health issues. Society will only be better for it.

 

Parting words of wisdom? If you have chronic fatigue, keep holding on to those things that make life feel worthwhile, and be kind to yourself. If you know someone with the condition, go and show them you care.

 

Thanks very much for reading, you’re all wonderful. Now go give someone one of these!

 

I need to have a lie down…

 

 

Useful stuff

I thought I’d post a couple of links to chronic fatigue-related stuff which can tell you a lot more than I can.

 

http://www.meassociation.org.uk/ – An organisation with heaps to offer those with chronic fatigue (or relatives/friends) – information, stories, a helpline, groups etc.

 

http://www.actionforme.org.uk/ – Similar to above!

 

http://www.freedomfromme.co.uk/ – Clinic which does great work with chronic fatigue and fibromyalgia

 

http://www.huffingtonpost.co.uk/2015/05/12/things-people-with-chronic-fatigue-want-you-to-know_n_7263604.html – Article on the Huffington Post acknowledging Chronic Fatigue Awareness Day

 

https://www.facebook.com/may12th.awareness – the Facebook page for Chronic Fatigue Awareness Day

 

http://www.michaelppowers.com/wisdom/rilke.htmlThe Man Watching, a poem by Rainer Maria Rilke about growing from our defeats, which I’ve found very inspiring (thanks Ben)

Publication: Using digital tools to engage the public in the policy process

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A paper I was commissioned to write exploring the use of online tools to engage the public in the UK policy process. It looks at:

  • The current UK context (including the recent PASC report)
  • Examples of opensource technology that have been successful, especially for policy
  • Opportunities and next steps to move this forward in the UK

Feedback and critique welcome!

 

Opensource policy platform brief

Publication: What’s Holding Us Back?

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I recently wrote a short paper critiquing the way we practice social innovation and social enterprise, based on observations and conversations from both the UK and Australia. It is borne out of growing frustration that despite huge amounts of time, finance and talent, we are not seeing any significant change in the underlying problems that people are trying to solve.

It highlights the mistakes that I have seen time and time again made by people and organisations trying to tackle social and environmental problems. It also presents opportunities for us to be more effective, and outlines potential steps we could take.

The paper can be downloaded below:

What’s holding us back

Taking a balanced perspective in an opinionated world

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A friend of mine recently said to me that ‘if you can’t see both sides of an argument, then you shouldn’t be arguing.’

 

It continues to amaze me when I see people announce a strongly-held one-sided view on some topic, whether it be religion, consumerism, politics or whatever else. These issues are divisive and controversial essentially because each side of the argument has strengths to it.

 

And yet attention is rarely given to those who sit on the fence. We like to listen to those who make a lot of noise and take a strong stance on one side – people like Richard Dawkins. I believe we perceive these people as intelligent, charismatic, strong characters. They’ve thought about a subject in depth and come to a firm conclusion. But were there not another valid side to the argument, the argument would not exist. All they’ve done by taking a strong stance on one side is to show that they are either a) lacking in empathy by being unable to understand another person’s perspective or b) too stubborn to acknowledge that they just might not be 100% right.

 

I believe we should pay more attention to those who can see and argue both sides. And often they will come to a conclusion that leans more on one side, but the crucial thing is that they have a balanced perspective. To me, these are the people who have genuinely thought about it in depth and are interested in the truth of the debate, rather than simply personal recognition.

 

This subject arose at the recent Anti-Hero launch at the RSA. They drew attention to the dominant model of leadership which rewards, amongst other things, those who take a firm and clear stance on subjects. They then pointed out that the nature of many complex problems is that they do have conflicting, strongly-held viewpoints and we need leaders who can understand both sides well enough in order to make the decision that benefits most.

 

Next time someone sits on a fence about an issue, don’t assume that it’s because they are weak or indecisive. Perhaps it is precisely because they have that rare ability to hold and balance two counter-argument simultaneously and see the bigger picture. I long held the belief that as we grow older and wiser, we will have much firmer opinions about the world. What I’m finding instead, is that as I increasingly see how complex and contrasting the world is, often it seems narrow or short-sighted to sit firmly and stubbornly on one side of argument.

The Unpredictability of Creativity

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The other day I was having a conversation in the pub with a friend about how unpredictable our bursts of creativity are. The following morning, appropriately, I woke up with this blog in my head and for reasons I can’t understand, this one too. Normally hangovers (2 and a half pints – that’s embarrassing) and lack of sleep conspire to prevent a single original thought entering my head, so why I woke up in a creative frame of mind is beyond me. It only goes to reaffirm the conversation my friend and I were having; creativity is a funny old thing.

 

How do we access our creativity? It’s a very pertinent question, and Elizabeth Gilbert’s very popular talk on TED goes to show that it’s one many of us are interested in. In her talk she reveals that on some days she sits down at her computer and that spark simply isn’t there – and this is from a bestselling author. It’s a conversation I’ve had many times with some of my more creative friends; some days it’s there, some days it’s not, and it’s hard to nail down why that is.

 

My take is that the triggers are deeply varied and complex, and I’m not so sure that a creative frame of mind is something that can just be switched on. Not to mention, each brain is different, and what works for one person may stifle creativity in another. What we can do is try to create the conditions that are conducive to creativity, that improve the likelihood of finding ourselves in a creative frame of mind. Although as I’ve said, these will vary from person to person. A few things that I find helpful are:

 

#1 Taking a mental break from whatever the creative activity is. I find that creativity comes more easily when my mind isn’t on the task and I’m not trying to force it. Somewhere in my unconscious ideas have been churning away, and I just need to give them the space to do so.

 

#2 Talking to people about the creativity activity. Interaction challenges and develops my ideas as I’m exposed to new ones. Sounds obvious, but sometimes we think people won’t be able to grasp our idea and so we stay quiet about it.

 

#3 Getting peace and quiet. There’s an unbelievable amount of noise in modern society, and so much information to be distracted by, which then occupies the mind. I know many writers who will shut themselves away somewhere isolated when they need to write, although this does make #2 difficult!

 

#4 Listening to music. This is a big one for me, but film and books can also inspire me. I recall reading not so long ago a neuroscience article about a study showing that music is good for creativity because of the areas of the brain it triggers activity in. There’s a good justification for playing music in the office!

 

#5 Mood. Confidence plays a big role in my creativity, so I need to be in quite a positive frame of mind. I know for some this is different – creativity is linked to any strong emotional state, positive or negative.

 

#6 Going for a walk! I’m not sure whether it’s the fresh air or the mild exercise, but after a walk I always come back refreshed with new ideas and focus.

 

What works for other people?

Reflections on FutureFest

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Last weekend I attended an event run by Nesta called FutureFest. I’ll give a quick rundown of what the event was about, my reflections on it (both how it was run and the questions that emerged from it), and the emerging technologies that could shape our future in a big way.

Outline

As the name suggests, the whole event was based around futurism and looked to answer a few key questions:

Where are we headed?

What future do we want to create?

How do we create it?

In terms of format, it was part talk-fest, part interactive. The main room was used almost exclusively for quick fire (20 minute) talks, and then we had panel/audience debates in another room. Downstairs was used for the ‘Imaginarium’, which was a mix of funky technology and organisations engaging you about the future-related work they’re doing.

 

Reflections

The conference was pretty slick and immersive, helped by a great venue; Shoreditch Town Hall. Although for me it was over-curated. I don’t go to conferences so much to be talked at, but rather to talk with people, and there wasn’t much space or time provided for spontaneous interaction with other attendees, which I always find to be the richest part of events. The speakers were a real mix, some were engaging and focused, others seemed to forget what they were supposed to talk about and meandered aimlessly.

That said, I certainly found the event as a whole very thought-provoking. The main insights for me were:

Our default view is of technology is that it is progress, but each tech should be put under the microscope and analysed for whether it is making the world better (i.e. more socially just/environmentally sustainable), not just whether it can be sold. Whilst science and business have many strengths, they pay no heed to ethics and such decisions should not be left to the market. One of my concerns is that our technology is fast beginning to outstrip our maturity as a species to know what best to do with it.

It’s very difficult for us to make wise judgements about the costs/benefits of new technology. The main context from which we make decisions is to ask ‘what is best for us as an individual tomorrow?’ What we need to ask is ‘what is best for society in ten years?’ i.e. using long-term, big picture thinking to make decisions.

Optimism bias was definitely on show, and what I mean by this is that we judge good things unusually likely to happen to us, negative things unusually unlikely – it’s an important little trick our minds play on us to inspire us to get up in the morning and keep going. However, I was glad to see some speakers acknowledge that we face some sizable challenges ahead, and technology alone is not the answer to all of them – in fact new technology also causes new problems, especially if we continue to neglect the unintended and inevitable negative consequences of it. Every technology has downsides too; perhaps our greatest technological breakthrough of the last few centuries – the use of fossil fuels for energy – has also provided us with perhaps the biggest problem of the 21st century; climate change.

I felt there were a lot of speakers/panelists too concerned with trying to look like experts, and trying to take black and white stances on some messy, complex issues in which the truth lies somewhere in between two conflicting viewpoints. They were busy looking clever rather than trying to find a better answer.

There was a great deal of agreement that civilization’s current macro-institutions (economics especially, but also politics, business, education etc) are growing increasingly outdated and that new ones will spring up sooner or later that are more capable of handling the challenges we face. Unfortunately, the questions of what these should look like and what methods we use to create them were left largely unasked.

Another take home was just how spectacularly wrong a lot of futurists get things when they try to predict the future! Apparently futurists have been predicting fewer working hours for decades and decades, and yet it is going the opposite way. This is an example though of where technology is not the answer – it is economics that represents the main barrier to shorter working hours rather than technology; the technology is already there for us to be working very short weeks.

And one of my favourite lines from the conference; ‘If we want better answers, we need to ask better questions.’

 

Radical future trends

A few things to look out for (some of which aren’t so far away at all)…

Sir Martin Rees suggested that with developments in genetics, within the next couple of centuries we will be in charge of evolution – not natural selection any longer.

A man in Austria recently had voluntary amputation in order to have a robotic hand installed. The world in which we choose to replace parts of ourselves with robotics is perhaps not so far away. One of the speakers was Bertolt Meyer, who himself has a robotic hand, and he speculated that he could even see this becoming a sign of status.

In China they are using gene-mapping to see what people’s talents are and how they should be raised to cultivate this. This immediately got me thinking about Aldous Huxley’s Brave New World

Soon we’ll be at a stage where 3D printers can print all the components necessary to make 3D printers!

 

And a few interesting technologies on show

Cancer Research UK found that, using their program, members of the public are 90-95% accurate in spotting cancer cells and will soon be opensourcing this out to the crowd to assist with finding cures for cancer.

The BBC have been working on surround visual TV, with images projected on the walls all around you whilst watching the program.

Potentially coming soon on Radio 5 Live (also from the BBC R&D department) listeners will be able to adjust the balance of volume between commentators and crowd, and choose which part of the crowd in the stadium they want to listen to.

BERG Cloud’s Little Printer, which is the smallest printer I’ve ever seen…

All in all, I’m really pleased I went – I learned a lot and made some great connections there. So a big thanks to Nesta for putting an event asking some very important questions.

On the privatisation of public services: An objection on principle

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Amidst all the excitement surrounding the recent privatisation of the Royal Mail, the delivery of public services has been on my mind*. It’s long given me a sense of unease watching the current government increasingly privatise our public services, and up until now I’ve been unable to put my finger on why. I’ve begun to realise that it’s essentially the contrasting bottom lines upon which private and public these sectors operate that troubles me.

Fundamentally the bottom line for private business is profit maximisation, rather than provision of quality services. To some extent the two go hand in hand, but it is crucial to acknowledge this motive for profit, because it prompts decision-making all the way down. Public services should be, as the name suggests, a service for the public, not a service provided to maximise private profit. Don’t blame the people at the top of corporates for making decisions with profit at heart, blame the legal business model (company limited by share) which means they are legally obliged to maximise shareholder profit. They’re just doing what they must.

You can see the problem in other public services e.g. provision of healthcare. There is no money in prevention, and from a business point of view prevention makes no sense – if successful enough you put yourself out of business. In contrast, there is a lot of money in pharmaceuticals though – a point made by a healthcare professional in a seminar I went to recently. In order for these pharmaceutical companies to survive they need to sell more drugs, it would be bad business if they prevented health problems from arising in the first place as they would soon find themselves out of business. There’s a real tension there between what is good for people and what is good for business.

A justification for privatising services is that competition drives up quality, and so the market naturally filters out all but the best services. There is truth in this, but it is a blinkered perspective. The market also favours companies with the best advertising, who are the best at making people feel inadequate without their product/service. The market favours companies manufacturing products with a short lifespan, so that people have to keep replacing their products every year irrespective of whether they are actually still adequate for the job (iPhone 11 anyone?). The market favours companies who use whatever methods they can get away with to maximise their shareholder profit, including exploitation and tax evasion. The market is not a barometer of what is in the best interests of the public, and a blunt tool when it comes to ethics in decision-making.

There is also the question of ownership to consider. Public services remain in the hands, in theory at least, of citizens. How do we feel about the Government of Singapore being one of the biggest shareholders in the Royal Mail?

Of course, I am in danger of taking a blinkered anti-business view myself. The private sector is less susceptible to the political infighting and jostling that can so harm public services. And it does open it up to competition, which drives up innovation and efficiency. Without this the quality of service can stagnate. Another advantage of using business to provide service for the public, is that if it is an effective service then it stands a good chance of making profit, and thereby growing as Michael Porter points out in this talk, and CSR is gradually becoming a much more fundamental part of how we do business. It is also important to acknowledge that government is responsible for regulating industries too, although it is debatable where the power of balance really lies here.

Public services have weaknesses too. They can end up as government cash cows, as occurred with our eastern rail services. The government, like business, is concerned with its economic turnover and operates each year with a budget deficit. The loans they attain from banks to make up this deficit grow in interest every year, increasing the pressure and forcing them to compromise around their implementation of public services.

In my view, social enterprise could have a crucial role to play here in the future in terms of providing a better balance of service. Community Interest Companies are worth keeping an eye on, as they balance public interest against economic goals. However, the social enterprise sector is not yet generally big enough to take on large public service contracts. B Corporations are also opening up the opportunities for business to serve the public.

Public sector, social enterprise and charity all have their flaws, but to me all are preferable models when it comes to delivering services for society compared to for profit business, simply because of the bottom line. So my objection is a philosophical one. Public services at least are somewhat democratic, and if the public are not happy they put pressure on government to improve. Charities will likely die out unless they are having a significant and demonstrable social impact now, likewise social enterprise. However business, at the moment at least, has one bottom line – maximise shareholder profit. In my view, that’s not a good enough motive from which to create a service for the public.

*This article has a good debate on the pros and cons of privatisation: http://www.independent.co.uk/voices/debate/royal-mail-privatisation-the-pros-and-cons-8814217.html

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