Why I’m quietly rooting for Lester Levy

Comment: Two contrasting events in the past week got me thinking about “localism’ in delivering social services. There is wide agreement on how desirable this is. It may be just my contrarian nature, but I’m wondering whether we all mean the same thing when we discuss it, and whether we really understand its implications.
At a conference for people chairing community organisations organised by Community Governance Aotearoa in Rotorua this week I was with a cross-section of voluntary services. Only a small slice of the 115,000 such not-for-profit organisations in the country but reasonably representative.
The huge number overall includes something like 28,000 charities, over 230,000 active volunteers, and over $30 billion of assets managed. From few people to many.  So it’s a big sector with some distinct governance issues.
Such organisations are all working on either some failure or inadequacy of markets.  Or central or local government. Or some community aspiration which has never been met from these sources.
They are vital organs of what sort of society we have and will have. They define us just as much as market brands or public services. Some are robust, but a great many are under real pressure from a combination of increasing demand and limited available resource.
I loved the positivity, aroha and determination of the leaders I was with. And what Community Governance Aotearoa is doing to support them.
The big burden they are carrying is funding. Not just the money, vital as it is, but the resources and the focus required to access and manage it. Whether public or philanthropic the funders increasingly require levels of information, structures of organisation and types of activity which they prefer and control and which comprise an increasing and often counter productive burden.
The community organisation becomes a servant of the funder more than the community. The cash dominates the kaupapa.
No one argues that there should not be accountability, nor that some areas of service could not be rationalised, but what starts as local initiative and delivery can become driven by external and internal bureaucracy and, frankly, become simply a lower cost option exploiting low paid or voluntary work rather than a vibrant expression of community need and response. We industrialise community initiative at great cost.
A day later I was at another function, quite different context and attendance. The health event convened by the NZ Initiative think tank also had a focus on localism. Less social activists and more insurers, investors and entrepreneurs.
This group can see both social problems for many and opportunity for them in the current health services malaise. Some are quite energised by the prospect.
We have a significantly private enterprise health services system, with public hospital service and government funding support. Some mixture of this kind, supported also by community services such as those served by Community Governance Aotearoa, is likely to prevail – though I suspect strongly that the private enterprise component will keep increasing its role, picking up from both government  and community services.
Government will be reduced to repairing health service potholes which may very well be its intention. There are plenty of them.
There is a fair bit of courting of Māori interests going on in this context. No surprise – Māori health is one of those areas of both market and government failure. Assertion of mana motuhake has created many kaupapa Māori services that face their version of the sort of issues other community agencies do. They are looking for alternatives and, if they can fund them or government will to an appropriate margin, then private enterprise will respond.
Localism in this context can mean either community self-reliance or commercial opportunity. You can’t blame either option being tried if there is the level of government failure there is and which seems unlikely to disappear.
That’s one of the reasons I found myself quietly rooting for Te Whatu Ora Commissioner Lester Levy when he spoke. He and his colleagues have an enormous challenge to deliver Pae Ora (which is still, even if its principles are largely ignored, the governing legislation).
With collapsing morale, buildings and services in the core operations and underfunding and confusion in the funding system, there is strong pressure for downwards spiral. To arrest that and to construct confidence is very tough and will call for tough decisions.
Just as the previous board was not the obstacle to that, neither will the commissioners be. The problem will be the competencies, motivations and capabilities of management (clinical and administrative).
The scale is hugely different quantitatively but qualitatively similar to that faced by the community sector. It’s one thing to allocate responsibility for delivery of a service but you also must ensure the resources and capabilities are there to deliver it.
For Te Whatu Ora this must first be found at national level, simultaneously at the regional level, and then at unit level in its own services and in designing and funding with local services.
It is true that, in principle, local government might play a role – but they need much capability building for that. The “localities” were intended for this purpose but faltered at birth and have been abandoned. The Iwi-Māori Partnership Boards potentially had such a role but the resource issues apply there as well.  
It’s one thing to propose or talk about localism. There is a lot of it out there but it is under great pressure. Unless what you mean is simply dismantling existing systems and leaving it to to the market, you have to build the capabilities to make it work.
“I tell you, folks, it’s harder than it looks,” as AC/DC put it years ago.
I’m sure “localism” in some way is central to really delivering Pae Ora but it’s not cheap and it’s not quick if you really want it to rock and roll.