What's holding us back?

Over the last couple of years I've facilitated a number of conversations with not for profit organisations who provide care services to people. Many of them have a long history, being among the oldest charities in Western Australia. They provide services to people who are marginalised in our community. People with disability, folks who are ageing, others who have a mental illness. 

Across Australia, in all three sectors there is major reform - some of the most significant changes we have seen in 100 years. The primary thrust of reforms are that people will have more choice and say in the services they receive, and they will have some control over how their service funding is spent. For the first time, they will be genuine customers, rather than simply consumers of service.

It's no small change. It's taken years to arrive. It's major disruption. There is both excitement and trepidation in the industry.

In the past human services organisations have operated using block funding. Each year a "block" of funding was paid to the organisation to run its services. Measures of success were things like hours provided, or number of beds. People using services had choices, but they were limited to homogenous services that were mostly unresponsive to their voice. It's not that agencies didn't care. Most organisations and people in them are set up specifically to make the world a better place in some way. The nature of funding simply meant that they were more answerable to funding bodies, than the people they served.

Over the last 10 years or so, there has been an increasing move to individual funding. People were assigned an amount of money based on need. Funding was still paid to organisations and service offerings were in a fairly narrow band.

The new reforms actually place money in the hands of the people needing the service. They get to choose who they spend it with. Organisations are needing to be more efficient, more customer responsive and more commercially minded.

So what has this got to do with expectations that keep us here? Historically, many people who have worked in human services have done so precisely because it is not a commercial environment. Many feel that a commercial element is more likely to be cut throat and uncaring. Most of the organisations I have worked with have expressed an expectation that looks something like this.

“If we do what it takes to survive in an environment of margins, cash flow and economies of scale we will be less caring to the people who need us the most. It will detract and distract us from our core purpose.”

With this expectation, participation in the new models of funding is unappealing and feels like selling out. But as with many expectations, it's not a binary choice. It's not either/or. The best way around expectations that constrain forward movement is to ask better questions. "What would it take to exceed our expectations about caring, and be more commercially smart?" " What are some great examples of large, profitable businesses whose customers love their services, and the way they are cared for?" "How can we ensure that our commercial models have people at the centre, rather than costs?"

Providing a great service = happy customers. Caring about them deeply = connection. If the recipe is right you will have more customers than you can provide a service to, and business is likely to be pretty good too.