From impact to relationships: Voluntary sector organisations in a changing environment

人们对人际关系在减少不平等方面的价值越来越感兴趣和理解。在大曼彻斯特，人们越来越意识到不平等的加剧。2007年，审计委员会公布了他们对大曼彻斯特健康不平等的两年研究结果(审计委员会，2007年)，这一点受到了特别关注。这项研究表明，尽管在医疗服务上投入了大量资金，但全市的健康不平等现象已经加剧，许多生活在贫困社区的人健康状况日益恶化。本报告中的一项关键建议是，需要与接触到更多非接触社区的社区组织接触，以便制定更具预防性的方法。这份报告引发了一场关于拥有强大关系的社区机构如何改变国家服务生产率的辩论，并推动了自那时以来香港公共服务改革的大部分思考，特别是在紧缩给现有系统带来压力的情况下。然而，发展中的模型仍将关系视为正式国家干预的前兆，而不是其本身的有效结果。这项研究的总体背景是国家与公民、服务与用户、个人与社区之间关系的变化--这些变化已经酝酿了近10年，但现在因应对2009年经济衰退和高额公共债务的政策而加速。组织、个人和社区被迫寻找新的工作方式。志愿组织在经济衰退前在提供公共服务方面发挥了关键作用，但自那以来特别容易受到公共服务削减的影响，尽管由于卫生不平等加剧和人口老龄化，对一系列保健和社会护理服务的需求日益增长。事实证明，规模较小、主要由志愿者运营并在基层运营的组织具有极强的弹性。日益增长的是，在经济衰退前的十年里蓬勃发展的志愿组织正在认识到，有必要更加关注防止对服务的依赖，赋予用户满足自己需求的能力，并为他们提供重新参与社区的有意义的方式。此外，已经转向由志愿人员领导的活动和社会行动，而不是由专业人员提供的服务。我们的经验是，当志愿组织对社区有一定程度的信任，使其能够解决可能被污名化的问题(即心理健康、贫困)时，这些方法往往更成功。在另一项研究计划中，GMCVO目前正在调查委托安排如何激励可能加强与社区、使用者和受益者关系的行为。这包括支持公共部门专员发展改变的交付文化，并在他们提供资源的组织中更多地关注社区。拟议的学生制度将进一步推动这项工作，对当地服务提供者(包括志愿者)和他们的用户之间在这种具有挑战性的组织变革背景下运行的日常互动和关系实践的性质进行深入的定性调查。这个项目着眼于志愿组织中存在的不同组关系，以确定关系在多大程度上影响组织如何交付其工作，不同组关系如何相互影响，以及这对组织支持服务用户了解自己的资产、成为社会参与者和过上充实的生活的能力意味着什么。

There is a growing interest and understanding of the value of human relationships in reducing inequalities. In Greater Manchester there has been an increasing awareness of the growth in inequalities. This was brought into particular focus when, in 2007, the Audit Commission published their findings of a two year study into health inequalities in Greater Manchester (Audit Commission, 2007). The study demonstrated that, despite significant spending in healthcare services, health inequalities had risen across the city, with many in deprived communities experiencing increasing deterioration in their health. A key recommendation in this report was the need to engage with community organisations that had reach into more disengaged communities, in order to develop more preventative approaches. This report stimulated a debate on how community institutions with strong relationships can transform the productivity of state services and has driven much of the thinking on public service reform in the city since this time, especially as austerity has created stresses on existing systems.However developing models still see relationships as a precursor to formal state intervention rather than as a valid outcome in themselves. The overall context of this research is one of changing relationships between state and citizens, services and users, and individuals and neighbourhoods - changes that have been in the making for almost a decade, but have now been accelerated by the policy response to the 2009 recession and to high public debt. Organisations, individuals and neighbourhoods have been forced to find new ways of working. Voluntary organisations which had, prior to the recession, developed key roles in public service delivery, have since been particularly vulnerable to public service cuts, despite growing demand for a range of health and social care services due to widening health inequalities and an ageing population. And organisations that are smaller, largely volunteer-run and operating at grassroots level have proven remarkably resilient.Increasingly, voluntary organisations which thrived during the decade before recession are recognising the need to adopt a heightened focus on preventing dependency on services and empowering users to meet their own needs, as well as offering them meaningful ways of re-engaging with the community. In addition there have been shifts to volunteer-led activity and social action rather than professionally delivered services. Our experience is that these approaches are often more successful when a voluntary organisation has a level of trust with a community that allows it to address issues that may be stigmatised (i.e. mental health, poverty).In a separate programme of research, GMCVO is currently investigating how commissioning arrangements can incentivise behaviours which might strengthen relationships with communities, users and beneficiaries. This includes work to support public sector commissioners to develop changed delivery cultures and grow more of a community focus in the organisations they resource. The proposed studentship will take this work further still, by conducting an in-depth qualitative investigation into the nature of the everyday interactions and relational practices which operate between service providers on the ground - including volunteers - and their users in this challenging context of organisational change.This project looks at different sets of relationships that exist in voluntary organisations in order to determine to what extent relationships influence how the organisation delivers its work, how different sets of relationships influence each other and what this means for the ability of the organisation to support service users in becoming aware of their own assets, becoming participants in society and living fulfilling lives.