Iain Gray: The pursuit of perfect is destroying the good

Managers in the care profession are too often swayed by fads, whatever the human cost might be, says Iain Gray

A recent Perspective column by Robin McAlpine (The Scotsman, 9 January) attracted a few laughs and some knowing smiles. Illustrated with a picture from Yes Minister, it elaborated 12 tactics employed by the civil service and public institutions to “kill off a good idea”, starting with the classic “set up an expert group”.

The piece was accurate, but there is a converse: when those same senior managers decide a new idea is going to happen and nothing will stand in its way.

Just after Robin’s piece appeared, I was at Leuchie House near North Berwick for a visit by Princess Anne, to celebrate its survival.

For years, Leuchie House provided ten-day holidays for sufferers of MS in a beautiful former convent. Its unique service model was run by the MS Society. Guests came with their carer, usually their husband or wife. However, all their caring responsibilities were carried out by Leuchie’s qualified and dedicated staff – the point being that this was a genuine holiday for both partners which they could enjoy together.

Guests have explained to me that the alternatives were either respite for the MS sufferer away from their family, or a family holiday which increased the caring burden on family members. Guests came from all over Scotland and beyond, and most returned again and again.

However, this kind of service did not fit in with fashionable thinking amongst care professionals. The MS Society believed that their members should access the same commercial short breaks and package holidays that everyone else does, that helping with these would be cheaper than subsidising breaks at Leuchie, and that Leuchie should close.

A major campaign resulted, and Leuchie reopened as an independent charity with support from East Lothian Council, the Scottish Government and many private supporters. It has made its holidays available to families living with other conditions, such as Motor Neurone Disease, and my latest visit convinced me that guests are as enthusiastic as they have ever been about what it provides. Plenty to celebrate then, although funds remain a challenge.

This is a classic example of a modern policy idea, with much to commend it, being used to justify shutting down what is there, even if it works. It is to make the best, the perfect, the enemy of the good, as Voltaire wrote. It happens all the time.

That same week, Gordon Brown made a rare speech in the House of Commons, supporting Remploy factories in Fife. The government is closing Remploy’s workshops, which employ thousands of disabled workers. The reasoning is, on the face of it, laudable. It says that all disabled workers should be able to get employment in the mainstream, and it will use the Remploy budget to help them do that.

When I was young and more idealistic, I would have agreed. I would have considered sheltered workplaces as ghettos for disabled workers, out of sight and out of mind. I still think that employers should not be allowed to discriminate against disabled workers. But I also know the world is imperfect, and I have seen how the best of sheltered factories, such as Blindcraft in Glasgow, produce high-quality products for commercial contracts with first-class conditions for a workforce who will never find work with a mainstream employer, especially when unemployment stands at 2.5 million. Of course we should have the best, supporting disabled workers in mainstream employment, but that does not mean we have to shut down the good sheltered employment opportunities.

Sometimes professionals, policy makers and public officials let a fashionable idea become a fad, and lose sight of reality. Believing that everyone should be able to work in mainstream employment is fine, but pretending that it is so comes at a cost. The TUC reports that, of the first 1,000 Remploy workers made redundant, 965 are still out of work, whatever support they have been given.

This happens repeatedly. When I was housing minister I had to veto civil service plans to make council housing illegal. Just because transferring housing to housing associations was a good solution where the quality of housing stock was poor and housing debt unmanageable, as in Glasgow, didn’t make it the right solution for somewhere like East Lothian where council housing was high quality, rents low and debt non-existent. But it was the fashionable thing to do. Just as the fashionable thing to do in housing 40 years before had been to demolish houses and build high-rise flats.

This is no argument against innovation. We just should not throw the baby out with the bath water in our enthusiasm for change. Politicians should be vigilant against the perfect being used to drive out the good.

For example, I strongly support the idea of social care tailored to the needs of the individual, but watch out for “web-based social care market navigation systems” coming to a council near you. The plan is that elderly and disabled people will design and construct their own care packages online. It is the latest thing; after all, doesn’t everyone shop, social-network and above all “choose” online?

No, they do not, and this is the same fashionable logic which is forcing the most stressed, most vulnerable and most chaotic of our citizens to apply for benefits online. It is a fad which thinks it is “cutting edge” to pretend to be the Amazon of the public sector. When it fails, those old-fashioned human care managers will be long gone.

Sometimes, those same forces which kill good ideas, nurture bad ones.

l Iain Gray is Labour MSP for East Lothian