COVID-19 AND SOCIAL DETERMINANTS OF HEALTH : wicked issues and relationalism

Health and socio-economic consequences of the COVID-19 pandemic have been exacerbated by central government-imposed austerity budgeting by local authorities and the health service. This book, part of the Social Determinants of Health series, extends the ideas developed in the previous volumes by reviewing the impact of COVID-19 on local and national governance from the perspectives of public health, social care and economic development. Drawing on case studies from across the UK and beyond, it explores the pandemic and other ‘wicked’ issues including climate change, homelessness, unemployment and domestic abuse through the lens of relationalism, and proposes necessary system changes. Front Cover Covid-19 and Social Determinants of Health: Wicked Issues and Relationalism Copyright information Dedication Table of contents List of figures and tables Notes on contributors Foreword Introduction The progression of COVID- 19 Climate change Understanding how to react to future shocks and stressors Roadmap for exploring this book References Part I Wicked issues and relationalism 1 Using relationalism to navigate wicked issues: investing for a ‘relational dividend’? Introduction The nature and governance of wicked problems Asking the ‘right’ questions Turning ‘defence’ to ‘offence’ The importance of relationalism in addressing wicked problems Relationalism as a ‘value proposition’ The relational imperative Relational work The relational dividend Conclusion References 2 Relationalism, wicked issues and social determinants of health Introduction Theories of relationalism Relationalism and values Geopolitical and regional perspectives of relationalism Relationalism and climate change Relationalism and the public sector Relationalism and the third sector Relationalism, culture and business development Conclusion Note References 3 Responding to the COVID-19 pandemic: a sociopolitical perspective Introduction Why adopt a sociopolitical perspective? Why has the UK government’s handling of COVID-19 been found wanting? Policy failures in addressing COVID-19 Centralised approach to policy choices and decision-making Austerity and its impact on the public sector Outsourcing to the private sector Going forward: an agenda for reform Conclusion References 4 Giving children the best start in life? Introduction The size of the challenge before the COVID-19 pandemic Progress on improving children’s health and wellbeing in the UK COVID-19 in the UK COVID-19: direct and indirect impacts Summary of the evidence: direct impacts Summary of the evidence: indirect impacts Intergenerational issues and intergenerational justice Call to action Conclusion References Part II Regionalism and geopolitical environments 5 Levelling up in the North and North-East England: complex and fragmented governance and the new National Health Service and local government partnerships Introduction Devolution and fragmentation of governance Quangos for recovery? Health and social care: the significance of the National Health Service’s long-term plan COVID-19: impacts on the North East region 2020/2021 Health and social care futures Conclusion Changing policy directions? References 6 UK local council strategies post- COVID-19: the local economy, climate change and community wellbeing Introduction Local authorities in England Building back better and greener Energy and buildings Active travel and air quality Partnership working Conclusion References 7.1 Case study: Racism and xenophobia – America’s deadly pre-existing conditions during the COVID-19 pandemic’s first year Introduction Structural racism’s mounting death toll Culture wars and clashes: the US political landscape during COVID-19 Conclusion References 7.2 Case study: Safe at home? Exploring intersecting vulnerabilities under COVID-19 and the role of faith actors in the South African context Introduction COVID-19 and violence against women and children Collaboration within the third sector including faith actors Conclusion Note References 7.3 Case study: COVID-19 and increased vulnerabilities to human trafficking and modern slavery – perspectives from India and Nepal Introduction COVID-19 situation in Nepal and India Increased vulnerabilities to modern slavery and human trafficking New forms of vulnerabilities Working together Conclusion References 7.4 Case study: COVID-19 and governing for health and wellbeing in New Zealand – putting communities at the centre Introduction Local governance and communities in New Zealand Rethinking the place of community What are some possibilities for the future of local governance in New Zealand? Conclusion References Part III Public sector, COVID-19 and culture change 8 The changing context of public governance and the need for innovation and creating public value Introduction The pressure for reform of public services globally The changing context of public governance Defining public and social value, and assessing historical antecedents The need for novel solutions to ‘wicked issues’: global, national and local ‘experimental and innovative governance’ Innovation in local governance to create ‘public and social value’ ‘Public and social value’ in the context of social determinants of health and inequality? Conclusion Notes References 9 The effect of COVID-19 on the financial sustainability of local government Introduction Going into the pandemic Council tax Business rate retention Increased sales, fees and charges income Growth in commercial income Effect on services from funding reductions Increase in demand Coping with increasing demand Protecting social care spend Conclusion on the sector going into the pandemic The scale of the crisis: pressure from four directions Increased cost from increasing demand for existing services and cost of provision Cost pressures from responding to COVID-19 Vanishing savings Falling locally generated income and tax losses The scale of the crisis: the Department for Levelling Up, Housing and Communities and central government action Unringfenced grants Specific grants Reducing burdens on local authorities Compensating for lost income The scale of the crisis: effect on economic development The local growth landscape from 2010 to 2011 The role of local authorities The ongoing effects of the pandemic Conclusion Short to medium term Long term References 10 UN sustainability goals and social value: local authority perspectives Introduction Global climate change concern The United Nations Framework Convention on Climate Change The Kyoto Protocol The Paris Agreement The Convention of the Parties The influence of the UN Sustainable Development Goals Historical perspectives on carbon emissions Key risk areas from climate change Extreme weather impact: flooding Extreme weather impact: heatwaves The role of local authorities in dealing with climate change Declaration of climate emergencies by local authorities Local authority areas of focus to combat emissions Clean Air Zones and transport related initiatives Reduction in housing related emissions Clean energy technologies Conclusion References 11 Housing policy and provision after COVID-19 Introduction A sectoral-based analysis Private sector Affordability Local authorities Housing associations Conclusion Notes References 12 Employment and support Introduction Employment support interventions Employment support and local government Employment support, funding and why the UK Shared Prosperity Fund matters References Part IV The third sector 13 Relational collaboration and innovation in responding to need and austerity: food banks Introduction Collaboration and innovation Innovation Constructing a frame for examples of collaboration and innovation Discussion and examples of collaboration and innovation Incremental innovation In existing products and services In new products and services In reducing cost As a requirement Institutional innovation In existing products and services In new products and services In reducing cost As a requirement Disruptive innovation In existing products and services In new products and services In reducing cost As a requirement Conclusion Notes References 14 Volunteering and small charities Introduction Background Charities, volunteering and social determinants Variations in volunteering rates The impact of COVID-19 on volunteering and on charities Conclusion References 15 Creating added value: the third sector, local and national government working together to address domestic abuse Introduction Domestic Abuse Act 2021 Prevalence of domestic abuse and COVID-19 Best practice partnership models The Coordinated Community Response A Whole Health Approach Commissioning domestic abuse services A commissioning case study: London Borough of Sutton ‘Transformation Programme’ Co-production and the voice of lived experiences Monitoring, evaluation and quality improvement Faith and voluntary sector response Case study: the Link Cafe, Merton Conclusion References 16 Wicked issues: a faith-based perspective Introduction The Salvation Army: a church and charity Social justice Case study 16.1: Being homeless in a pandemic Operating under different parliaments: central and local governments Case study 16.2: Older people, care homes and COVID-19 Case study 16.3: Human trafficking in a pandemic: an international perspective Introduction The Salvation Army International Anti-Trafficking and Modern Slavery projects Impact of COVID-19 on communities supported by The Salvation Army in the UK and across the world The Salvation Army and Home Office victim support contract in the UK Case study 16.4: Supporting people in the community: the development of an evidence-based approach Conclusion Notes References Part V The case for relationalism 17.1 Case study: A relationalism exemplar 17.2 Case study: Housing and homelessness Introduction Context Solutions The forgotten 50 per cent Conclusion References 17.3 Case study: Environmental planning in a post-COVID-19 world Introduction Conclusion References 17.4 Case study: Central England Co-operative society Introduction Social value through cooperation Cooperating on wicked issues Access to food and food waste Addiction and retail crime Climate change Conclusion Notes References Part VI Engagement and proposed changes 18 Soft and hard measures in optimising wellbeing through procurement, commissioning and partnering Introduction Social value in public procurement: recent developments Procurement post- Brexit and the embedding of social value inprojects appraisal How good governance creates the framework for success inpartnering relationships Taking commissioning and contracting beyond a binaryrelationship Note References 19 Relational procurement: translating lessons learned from large infrastructural projects Introduction Relational contracting in the construction industry Complexities and challenges of partnering The public– private dimension of partnering in construction Implications for public– private partnership, wicked problemsand health issues Conclusion References 20 The impact of ‘the lost decade’ on developing a relational culture in public–private partnering Introduction The widening inequalities gap The background to ‘the lost decade’ The rise and decline of austerity The EU referendum, the ‘left behind’ and ‘levelling up’ Conclusion References 21 When the politically impossiblebecomes the politically inevitable: hasthe moment arrived for the wholesaleadoption of relationism? Introduction Unpacking relationism Enhancing inter- organisational relationships Improving bilateral relationships Improving networks of relationships Enhancing extra- organisational relationships What holds back relationism? Might the COVID- 19 crisis beget a new era of reform? A strong intellectual foundation for the new approach Adoption of the ideas by the main political parties The consent of voters to implement the ideas Conclusion Acknowledgements Notes References Conclusion Relationalism and wicked issues Wicked issues and politics Business as usual? COVID- 19 and the social determinants of health Levelling up or levelling down? References Appendix: The Centre for Partnering Recommendations for system change Index