Malin Arvidson, who is part of the Third Sector Research Centre, gave a seminar yesterday about some of the work she has been doing on the Real Times project. The Real Times project is longitudinal (which means that it follows people and organisations over time) and qualitative (think in-depth interviews, as opposed to check-box questionnaires). Qualitative research isn’t really… well, it isn’t really me. I like to have data. But, I am human, so I like to hear personal stories too, and that’s one of the things that qualitative research is really good for.
Arvidson has been interviewing paid staff (in this case highly-qualified professional paid staff) at a mental health charity in England. Some of the staff were motivated by their own experience of mental health problems, but all felt what she called a ‘commitment to care’. She was interested in looking at the conflicts which can arise between a charity’s espoused values, the values held by its paid staff and those ‘forced’ on it from outside (perhaps by central or local government contracts). The really interesting point for me was raised at the end: surely these conflicts aren’t found only in charities, only in the third sector?
Personal values, professional values, organisational values and societal values cannot be expected to entirely coincide. Take health care. Charities first… Sure, you get the conflict in a health care charity. One of the staff Arvidson spoke to talked about the difficulties inherent in the advocacy role. An advocate speaks up for their client and gives them a voice. The advocate’s job is to explain the client to the (usually official) world. Sometimes, though, the advocate would really like to explain the world to the client – but that is not in the job description. In fact, it’s explicitly excluded from the job description. Personal and professional values clash. The advocate may not encourage the client to, say, engage constructively with a social worker, even when the advocate feels that it would be in the client’s best interests to do so.
So, now the state sector. This one’s easy. Think of an emergency medical technician, working on an ambulance. She’s in the business of helping people who are sick or injured – that’s what’s in her job description. Some people bring illness and injury on themselves, but it’s important to her to behave in a non-judgemental fashion. And then there are drunk people. They pass out on the pavement, members of the public call ambulances and they suddenly become her problem. They are not sick or injured. They do not require medical assistance. And yet they clearly need some assistance. She has to help, but feels conflicted.
And finally, the private sector (thanks to Ben Mason for this example – although it’s really one I should have been able to come up with myself, given my professional background). Take the insurance industry. It mostly exists to make a profit (excepting the mutuals, whose happy band includes even very large companies like Bupa). Helping people is in the mix, but making a profit has to come first (or how will anyone get helped)? A staff member can hold that idea in their heads, but still have problem refusing a payment to someone who should have disclosed a pre-existing condition but didn’t, for some completely understandable reason. And there’s the conflict again.
Is there really a difference between the conflicts of values inherent within charities, within the NHS and within private medical insurers? Hmmm… Tough one.