Here are a couple of paragraphs that I think capture the message, but the whole article is worth the read.
“…the best guide to how these new public services might operate is an iconoclastic former Catholic priest and visionary who wrote his best work 30 years ago: Ivan Illich. Illich was a critic of industrial society who, in a series of polemical books in the 1970s, set about the failings of modern institutions and the professionals who organise them: Deschooling Society, Limits to Medicine, Disabling Professions and Tools for Conviviality. He was ahead of his time by being behind the times. His critique of industrialisation harked back to pre-industrial, more communal forms of organisation, in which local, low-technology production met most demand. He also foresaw a post-industrial world, using the language of networks and webs long before the internet…
Ivan Illich’s genius was to realise, 30 years ago, that this would be not just desirable but would become a necessity. A tax-funded public sector built around passive consumers cannot hope to keep meeting people’s rising expectations for tailored services. The only way to personalise services to different needs, on a grand scale and at affordable cost, is to motivate and equip the users to become players, not spectators. Imagine an education system built around the participatory principles of Wikipedia, or a social care system that was as simple to take part in as eBay. In future we will need public services produced by the masses, not just for the masses.”
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Leadbeater writes, “A tax-funded public sector built around passive consumers cannot hope to keep meeting people’s rising expectations for tailored services. The only way to personalise services to different needs, on a grand scale and at affordable cost, is to motivate and equip the users to become players, not spectators.”
Indeed, Illich saw the rising expectations and the rising demand for services that could not be met. But his response was not to call for consumers of health care to become service providers themselves, “to become players, not spectators.” Illich called for people to effectively reject and drop out of the “health care system” – to radically question its premises and axioms and to rethink what words like “health” and “care” have come to mean – and what they might possibly mean in different circumstances. He called for qualitative, not quantitative health care. He called for a renunciation of the health system’s (very modern and unprecedented) requirement that we all feel “responsible” for our health and that we strive at all costs to reach some profesionally-defined state of health.
Especially in his later life, Illich recognized the evil of “systems” – as opposed to tools – and sought to break out of their grip.
At the Bremen website devoted to Illich (www.pudel.uni-bremen.de/), you will find a paper of his – in fact, only one of several of his that are relevant to this discussion – titled “HEALTH AS ONE’S OWN RESPONSIBILITY – NO, THANK YOU!”
There, Illich states the following:
“I demand certain liberties for those who would celebrate living rather than preserve “life:”
– the liberty to declare myself sick;
– the liberty to refuse any and all medical
treatment at any time;
– the liberty to take any drug or treatment of my
own choosing;
– the liberty to be treated by the person of my
choice, that is, by anyone in the
community who feels called to the practice of healing, whether that person be an
acupuncturist, a homeopathic physician, a neurosurgeon, an astrologer, a witch
doctor, or someone else;
– the liberty to die without diagnosis.
“I do not believe that countries need a national “health” policy, something given to their
citizens. Rather, the latter need the courageous virtue to face certain truths:
– we will never eliminate pain;
– we will not cure all disorders;
– we will certainly die.
“Therefore, as sensible creatures, we must face the fact that the pursuit of health may be a
sickening disorder. There are no scientific, technological solutions. There is the daily task of
acccepting the fragility and contingency of the human situation. There are reasonable limits which must be placed on conventional “health” care. We urgently need to define anew what duties belong to us as persons, what pertains to our communities, what we relinquish to the state. …”
Evidently, Leadbeater has missed this part of Illich’s argument, or perhaps willfully ignored it.