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Dominic Williamson

Turning the Tide - a vision for multiple needs

14 September 2011

Ollie and Dominic speech for Vision Paper launch: Turning the Tide


Thank you Andrew, and David. And thank you all for being here.

One evening a few weeks ago, I was heading home after having dinner with a friend near London Bridge.  It was a lovely, warm evening and the streets were busy with people socialising after work.  As I walked towards the tube station, I noticed a woman weaving through the crowd.  Around 30 years old, she was bone-thin, her clothes were filthy, her face bruised and streaked with dirt. She was clutching a can of Special Brew and asking passers-by for “change for a bus”. 

People swerved or sped up to avoid her, looking away. The contrast was stark.

In the midst of all this prosperity and friendship, here was someone whose life had clearly come off the rails.  In those moments it’s easy to feel helpless. What can I do?  We’ve all felt it.  We hope that someone will make sure she gets the help she needs.  We hope that someone, somewhere, is taking responsibility for her.  But the truth: no one is. 

Because there is a responsibility gap in our social fabric - and as a result, too many people are falling through.

The Vision Paper we are launching today aims to address that gap.  And turn the tide - for people like that woman I saw in London Bridge, and thousands of others across the country.  People who are marginalised and often unrecognised in our society – people experiencing multiple needs and exclusions.  

It throws down a challenge:  can we come together, and take responsibility? Can we commit the political will to say: this is not good enough? Everyone in this room has a role to play.

But who exactly are we talking about? Labels are difficult. Every individual is different.  The government has already recognised a broad group of people facing “multiple disadvantage”.  But we are talking about a smaller group within this.  Individuals who require a specific response.  In the past we have lacked a clear definition of this group, which has blocked political progress.  But the Vision Paper offers a definition that works.

It has three elements:

First, people facing multiple needs and exclusions experience several problems at the same time: mental ill health, homelessness, drug and alcohol misuse, offending, family breakdown.  These problems are interrelated and exacerbate each other.  As we saw so clearly in the Joseph Rowntree report published yesterday.

Second, people have ineffective contact with services.  While they have often looked for help, services see them as: “not my problem”.  Because these services are mostly designed to deal with one problem at a time. To support people with single, severe conditions.  And people with multiple needs often fail to reach the threshold for help.

It is this interplay between multiple needs and exclusion from services that leads to the third characteristic. That they are living chaotic lives.  Lacking effective support from services, people like the woman I talked about earlier, easily end up passed from pillar to post.  Adrift from family or friends.  And trapped in chaotic lives where escape seems impossible, with no one offering a way out.

But why should we do something about it?  Our failure to tackle this issue is costly and damages our society.  It means people continue to harm themselves and their families.  Communities suffer crime and antisocial behaviour.  It means that our emergency services spend so much time dealing with this group that their response to others is affected.  And all this amounts to a huge cost to the public purse.

But most of all, by failing to act we are wasting the potential of people who can, and should, be part of our communities, not shut out from the opportunities that we all take for granted.  The contribution of the many people here today who have turned their lives around shows what can be achieved and what could be achieved for many if we can turn the tide.


Our Vision

So what do we want to see happen?

We have a clear vision:  That in every local area, people experiencing multiple needs are supported by effective coordinated services.  And empowered to tackle their problems.

Take Tom for instance –with us this evening..  He leads work in Cambridgeshire targeting 15 people facing multiple needs and exclusions. The most chaotic individuals in the area.  Using a very personalised approach he builds their trust.  And because of a strong strategic commitment from partners he can pull together the flexible, multi-agency responses these people need.  There is excellent work happening in Cambridgeshire.  But even there it is clear that local areas can’t achieve the vision alone. Too often, they find themselves swimming against the tide.

A new approach is needed from national government to turn this tide, and to create an environment in which it becomes the norm for leaders in local areas to put coordinated services in place.  

Distance travelled

Luckily, we are not starting from scratch:  Commitment from MPs and peers shows that this is a cross party issue.  There is recognition of multiple needs in the government’s mental health, drugs and rough sleeping strategies.  And the Prime Minister himself has made a personal commitment to “troubled families with multiple problems”.

Joining it up

But these actions, important as they are, do not add up to a new approach.  They will not be enough to achieve the vision in every local area.  For that, much more is needed. The paper you have in your hands sets out five building blocks for government in achieving a new approach.   I’d like to mention just three: 

A clear message

Firstly, we need national leadership.  

A clear message from the top that multiple needs is a government priority.   If government is committed to protecting the most vulnerable and reducing the deficit then tackling multiple needs is a good place to start. We want to see a government strategy that says to local areas: “Multiple needs is core to our understanding of social justice.”  That says: “We are doing our bit to achieve the vision. Now you too must act to put coordinated services in place.”


Secondly, we need to address the fact that no one locally or nationally is currently responsible for this group.  

People facing multiple needs are vicitmised, neglected and die prematurely, yet this nearly always goes unchallenged.  When this happens to a social services client, there is outrage.  The Director of Social Services has questions to answer.  But for the woman Dominic mentioned earlier – known to everyone but served by no-one – the situation is ignored.  We must make someone responsible in every local area for ensuring effective, coordinated support for this group.


Finally, we need to get the finances right. 

Multiple needs means multiple budgets.  The way government finance works doesn’t bring services together.  The Vision Paper sets out how we can create area-wide financial incentives for commissioners to work together andput coordinated services in place.

Time to turn the tide

Together these changes are a new approach.  A new approach to how we support the most excluded in our society.  A new approach that needs to be led from the top. by a group of Ministers that have a cross-government overview of policy.

We are particularly pleased therefore to have the Mr Letwin and Dr Blackman-Woods with us this evening. Mr Letwin is Minister for Government Policy and a key member of the Social Justice Cabinet Committee – a group well placed to lead the new approach we need.

Minister, Dr Blackman Woods, we welcome you this evening.  We hope that together we can begin to turn the tide - for the young woman Dominic mentioned earlier and for the many others like her around the country.


Thank you.

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