Lesley Riddoch: Strategic spending on communities could change the health and behaviour of people living in them

ALEX Salmond’s Cabinet reshuffle has left Nicola Sturgeon and Alex Neil with swapped jobs, “up-sized” portfolios, high profiles, raised status … and a unique opportunity to do something far more important even than the sum of their two, new, super-sized jobs.

These powerful, popular social democrats could together demolish the silo mentality that bedevils public service delivery in Scotland and end a culture of paternalistic, top-down governance.

But will they?

Nicola Sturgeon is already busy. The new Cabinet secretary for infrastructure, investment and cities must also manage the independence referendum, formulate government strategy and co-ordinate policy delivery across portfolios.

Co-ordination is no mean feat and yet with public money tight and economic vital signs weak, nothing is more important. Viewers of the compelling 2007 TV series Can Gerry Robinson fix the NHS? will know the answer was a tearful, frustrating, but emphatic no. Getting Scotland’s public services (local, central and quango) to work with one another has hitherto been the stuff of dreams – never mind involving the voluntary and community sectors, users groups or the public.

Now such a broad coalition of forces is vital.

Put bluntly, the chances of Scots shrugging off our unwanted reputation as Sick Man (and Woman) of Europe are nil unless wasteful duplication, unco-ordinated spending, silo-thinking, chronic risk-aversion, defensiveness and suspicion between public service providers and everyone else, distant unaccountable authority, process-led service provision, top-down government and local disempowerment end forthwith.

Highbrow-sounding stuff, I’ll grant you, and far easier to open another new A&E department instead. But Scotland’s dismal health outcomes (now the responsibility of Alex Neil) will only change dramatically when housing, communities and regeneration spending (now the responsibility of Nicola Sturgeon) is targeted strategically.

West Whitlawburn Housing Co-operative (WWHC) is a prime example of (inadvertently) getting it right. £2.2 million of public cash in 1988 let Glasgow tenants take over the ownership, management and renovation of 540 flats and has paid for itself many times over in reduced emergency hospital admissions and state care provision. Eleven deaths have been directly averted thanks to alarms and CCTV monitored round the clock by support staff ready to visit an old person’s flat at 2am with a cup of tea or intervene if they see epileptic fits on camera.

Violence and anti-social behaviour have been reduced (along with the costly re-housing budget) and the co-op is tackling drink, dietary and skills problems amongst tenants. “Social accounts” produced by WWHC list the multitude of ways in which a well-managed, self-regulating, community can protect human dignity, devise efficient systems – and save cash.

Oxfam’s Humankind Index shows the joint top priorities of Scots are affordable, safe and decent homes and physical and mental health – closely followed by living in a neighbourhood where you can enjoy going outdoors and a clean and healthy environment.

The public intuitively understands the relationship many public servants still deny. Health, housing and local life are all connected. People and place are connected. And just as better health outcomes cannot be “done to” passive, disempowered people, better housing cannot be “done to” them either.

A hundred people-controlled West Whitlawburns would reduce hospital admissions faster than any health advertising campaign. But the housing budget is now beyond Alex Neil’s remit – unless he and Nicola Sturgeon can think long term, break the rules and share budgets.

They certainly have the insight.

Thanks to their previous “day jobs” no two people are more aware of the symbiotic relationship between health, housing and local democracy than the two ministerial job swappers. But can they act radically to empower communities without prompting a backlash?

Last week’s Development Trust Scotland conference was probably Alex Neil’s last public incarnation as communities minister and he delivered a confident, knowing analysis of Scotland’s “lifeless” town centres. It’s no coincidence the parlous state of our economic health is so vividly captured by the terminology of human decline. People and place cannot be separated.

And yet in Scotland they are.

Last month’s Scottish Household Survey revealed only 22 per cent of Scots think they can affect the place they live. That’s a terrible condemnation of Scottish democracy. The local area is where every important tax-funded service is delivered – schools, doctors, roads, housing and care. Local is also where Scots should connect with other people – neighbours, clubs, campaigns and projects that expand us as citizens and human beings. Local should be the most important dimension in our lives. And yet almost four-fifths of Scots think their neck of the woods is run by other people – not folk like themselves. And they’re right.

Scotland has the biggest “local” authorities in Europe by population and physical size with the lowest proportion of people standing as candidates and the lowest turnouts. The French are almost crazily local – their smallest commune has just 89 people. In Spain the average is 600 people, in Norway 4,000, in Germany 7,000 and in Scotland – a whopping 115,000. Scotland is structurally at the wrong end of the European localism league table.

Ministers privately agree that the community is the best level for effective service delivery – yet it’s the domain of unresourced volunteers. Councils could help by transferring land, buildings and budget to communities but hostility and obstruction towards community takeovers is more common.

It doesn’t have to be this way and Alex and Nicola both know it.

Capable, connected, powerful communities could generate energy, supply district heating, find work for unemployed young people, tackle local flooding problems, fix derelict buildings and keep an eye on old folk – helping them stay out of hospital and the personal care budget stay under control. In Sweden, a town like St Andrews would have its own council, collect all taxes and pass on to Stockholm the small fraction needed for national services.

Already community trusts own and run affordable local housing, shops, transport, food co-operatives, libraries, village halls and wind turbines from Shetland to the Borders. And yet hardly any are elected councillors.

Places are dying – largely because of remote, wrong-sized governance while Scotland’s communities are bursting with talent, capacity, problem-solving energy, history and resources.

Architect Malcolm Fraser has welcomed the breadth of his newly announced town centres review. If it also recommends more power for towns and communities, will the SNP act or look the other way?

It’s up to Nicola and Alex.