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Compassionate Community and Big Society

Whatever one’s political leaning, the Big Society looks as if it is here to stay. Despite general public apathy during the election campaign, it’s clear that the Big Society is Cameron’s Big Idea (though not necessarily the Conservative’s). Think Tony Blair and the Third Way – another BI hat failed to excite the public but did genuinely raise debate in academic and public service circles.


The Big Society aims to challenge public apathy and ‘creating a nation of empowered citizens and communities’ as the website declares. The first part of the statement surely links to the aims of the Compassionate Community campaign. Raising awareness, challenging preconceptions and increasing understanding are among the campaign’s goals – and the second half of the statement MUST follow: with a clearer understanding comes greater power.


Similarly just as the ideological background of the Big Society is the belief that government doesn’t always know [or do] best, so one of the Compassionate Community’s principals is that end of life is not just the sole preserve of the Medical Profession in all its many manifestations – from doctors to lawyers, salesman to scientists.


Indeed it could be concluded that the idea behind the Compassionate Community provided the template for the Big Society: wider community involvement, a challenge to the status quo and ultimately an attempt to make a real difference to people’s lives - and deaths.


Like the Big Society’s challenge to the role of government, the Compassion Community aims to question the ‘nationalisation’ of death. The old nationalised industries certainly had many pluses – maintaining employment and investment for example – but they masked the true costs and ultimately became unresponsive monolithic juggernauts unfit for purpose.


By ‘nationalizing’ death we – because we have nearly all become complicit – became grateful that the state and the state dependent sector dealt with the questions that end of life and death posed. Individuals had to take less and less responsibility and ceded many decisions to the state. However, we are now beginning to realise the state cannot respond effectively to continuing changes in medical knowledge, societies growing diversity and individual needs and responses.  A ‘one size fits all’ approach simply doesn’t work in a mature, multi-ethnic democracy.


But it doesn’t take an historian to know that after nationalisation came privatisation. It bought benefits too – but often concentrated essential services for the many in the hands of the few. The Compassionate Community and Big Society need be aware that, whilst challenging the status quo, the result is not to switch power and responsibility to organisations whose motives may not be compatible with a free, equal society.


Using business as a model or metaphor is not always appropriate, but I think useful in the case of the Big Society and the Compassionate Community. Modern businesses are taught to ‘think globally, act locally’ and it is a good example to set. Both need to be aware of the big picture, but also be responsive to what works at a community level.


Putting aside the issue of funding, the idea of increased involvement and empowerment cannot, in principle, be anything other than welcome. But we need to be realistic; to make a real difference takes a commitment of time, energy and often money beyond most working people. Political organisations, religious groups and the leisured classes lack neither time, energy nor money but will bring their own ideological aims. That’s not necessarily bad, but it needs monitoring and perhaps counter balancing – and that requires time, energy and often money. Hopefully you get the paradox.


The challenge then is a double one for both the Compassionate Community and the Big Society: improve empowerment and increase involvement by all means, but avoid becoming the latest prizes in an ideological battle.


Brett Sidaway contributes as a non-specialist to website. He lives and works in Birmingham UK Brett Sidaway

Sandwell Compassionate Communities - End Of Life Care & Support - Coping with Death and Dying - Palliative Care

Murray HallBridgesNHS West MidlandsSandwell NHS