Little Side note: What is the role of the Government in this Bottom-up Open Care project?

When discussing society’s biggest questions I like to have a discussion with Ginette Bauwens, a figure of the activist scene in Brussels and well-spoken about any subject. She has the looks of a friendly grandmother but the vivacity and energy of a young activist that believes in the power of humans. She played an active role in the recent car free shift of the centre of Brussels but made sure it didn’t become a gentrified zone. She majored in philosophy and made the choice to work all her live half time so she could invest her time in local or global movements.

First when I asked her to give a short opinion about the bottom up imitatives organizing care related projects she responded: I only believe people can give care when it comes from love and friendship. All other forms need to be done by the government to be effective. I was really surprised by this ballsy argument so I invited over for a drink on the hottest day of the year (35°C!) and we had a tomato juice and a great conversation.

We dived immediately into the subject. Care is a government issue for  her that isn’t at all taken care (pun intended) of. Why does the government give as much power to the pharmaceutical industry for example? Why can Nestlé become the number one partner of a government organization called ‘Kind En Gezin’ that helps parents of new-born through the first year? For her our role as activist and change makers is to put pressure on the government to make change on a big scale possible.

I explain her how local initiatives are bending the system like the open insulin, chemotherapy in Romania or ways that people are hacking neuroprosthetis. Even if she find them great initiative she is scared that it will not be scalable, for her if the government doesn’t follow, nothing will change on the long term. I ask her why even within this idea people are rather trying to find solutions themselves then going in the street and pressuring the government. It makes sense, she says, you have an illusion doing something more meaningful while starting a project, then putting pressure on a government where the reward will (maybe) be given after many years. Instant gratification is much more popular, and with bureaucratic complexification people are less temped to get into a long battle with the government.

But Ginette isn’t the person to only be sceptic and give critic towards ideas. She likes finding solutions. So before I explain her the principle of the workshop we talk a bit further on the big problems ahead. For her everything can be put into three categories: poverty, elderly care and work ethics. Poverty makes it impossible to take care of each other; it is a vicious circle that is difficult to get out of. Even with the best projects, people without money will not get towards it. Elderly care is also a big problem in European countries, care became profit and it is all about efficiency. Only a rearrangement about how we look at elderly care can get us out of this problem. Finally there is the way we look at work and how it makes us sick: burn out is one of the biggest epidemics of this century and involves pulls the whole family downwards. Not one political party is discussing these problems on a larger scale and that is problematic for her. The resources are there, but the unwillingness of changing is bigger. Politicians aren’t trained to be vectors of change; they are the ones that bring continuity. It’s the civilians that need to push the change and politics to implement it.

Dark times ahead? Maybe, but this discussion made me think more clearly about the workshop and what we need to take notice of when bringing care-project together. Like within the makers movement it is important to find a balance between corporate and counter culture partners, within care it is also important to have an open approach towards policy makers. Yes we are in a ruff path at the moment, and trust is at an all time low towards politicians. But therefor it is the moment to open our arms to welcome them towards new ways of organizing care. We need much more and easier collaboration between projects. We need especially that knowledge of the government to tackle complex problems with multiple partners. We need to take them by the hand and show them what there is possible within an open care system

The discussion I want to open towards the community is: Is involving the policy makers important, or will it be obsolete in the future? What kind of dialogue can care taking projects take towards it?

Learning from concrete wins or lost battles?

I’m grateful to Ginette for her opinions and super curious to see if she has experienced victories too in her work, even small ones. In a conversation I had the other day with a friend well versed in NGO work and having quit, she mentioned something suprising to me: that for her it is the proper third sector having a chance of changing things, not the bottom up grassroots. So you see, all sorts of distinctions are being made, but I recognize the bottom line - the need for structured processes, paths to access resources, influence etc.

My opinion is not worth much, in fact we can be right and agreeing and still not go anywhere :-| From the years I’ve been working in this field, what I’ve seen is doors opening and an ability from policy makers to listen. With unMonastery called in by a city, Futurespotters by UNDP, new doors opening thanks to them and other consultancy work, and so on. It feels to me hard to think about large scale change, but seeing a progression makes me more hopeful than at time zero, if that means much. If Edgeryders is anything of a counter culture movement, than it is also true that from the beginning the position was to open channels for collaboration between very diverse people. And guess what: over the years people in policy making have joined too, and were honest about their own limitations as institution representatives - for example, this is someone who at the time of engaging was in the Amsterdam City Council and here asking about basic income and how it would work.

So to me, if OpenCare with the workshops and future activities manages to open a real channel, that is already a win. Then to move forward, I can see the need for someone to pick their battles and perseverate in that… and who knows how long that takes.

Re one of the three areas mentioned by G. Bauwens - Burn Out

One main finding made by field researchers about burn out is that one of the main factors that leads people to burn out is “ethical suffering” (litteral translation of the original expression in French “souffrance éthique”) and this before workload.

What does that mean ? Stress often comes from a conflict of values between prescribed work and “real” work, “real” in the sense of what really has to be done in a correct way.

A large amount of professionals who get burnt out couldn’t live anymore with the contradiction between what is asked and what should really be done. And I don’t speak about ethics from ideological point of view. Just the tension between what is asked and what true professionals believe should be done (eg : social workers in big institutions, engineers in industrial companies, nurses in hospitals,…). The fact that there is no place anymore for true dialogue, exchanges and co-construction around their own practices worsened the situation.

So bringing "real’ work in the center of the operations by giving back the floor to those who act is a way that is currently implemented in a few organizations to significantly reduce the risk of burn out. By organizations, I mean not-for-profit, for-profit or public organizations. None of them is immune to this illness…especially the not-for-profit ones like NGOs.

And this is without mentioning the ethical conflicts that workers can have between their own values and those shown withing the organizations they work for. And this is another (big) story.

“giving back the floor to those who act”

@Philippe_Drouillon welcome back! This ethical suffering idea of yours reads really interesting, I can see your point and will try to add something to it.

By new ways of giving back the floor to doers, do you mean new decision making models? Or more tolerance for the doers in an organisation run in traditional way, a way of compromising?

Our community conversations so far mention burnout in entirely new kinds of organisations growing from bottom up movements. You’d say these new orgs could be better candidates for diminishing that tension and ethical conflict. I myself am an exhibit of that. But you also see people like @marcoclausen reporting cases of community activists lost in simply too many requirements which they hadn’t signed up for.  They come with the “job description” so to speak, especially in a non-sustainable environment where you have to compensate for roles you can’t afford to pay for. So you have cases of burnout because of simple overwork, even with passsion and alignment between what is required and what you want to do.

Curious, from your experience of working with both co-ops and more traditional businesses: is sustainability of an organisation correlated with healthiness of work? Here I mean the quality of what it produces, its impact. Maybe if there were some roadmaps or a system of sustainability rewards that come with keeping healthy at work, at the expense of some other things, we’d get better at moving our work forward.

Shift away from political activism

Nice input from Ginette and valid points.

Last week I had several conversations with philosophy friends of mine who noted the same in their research or otherwise. They made some interesting points. I tried to reconstruct them, but there might be some holes in it.

Most ‘activism’ today is done by do-ers. Bottom-up initiatives that took it upon themselves to solve problems that governments should take care of. They noted that this shift to just getting your hands dirty and not wait for government action is actually quite a neo-liberal way of solving problems.

The ideal of May '68 has become ingrained in the way the mainstream thinks. The loss of faith in government and institutions has become part of a normal way of thinking. Management and corporations have adopted it in a way: they want to get rid of the old and slow processes, they want radical disruption asap and would like as few interventions by government as possible. Government is mainly seen as an obstacle at this point.

Bottom-up initiatives follow the same reasoning to a large extent. Government is one of the obstacles to be overcome, because they’re perceived as ingerently part of the problem, almost an external factor that is unchangeable. But they have to do it with less means, less people and less power (leading to the burnout problem). Additionally, the whole neo-liberal side will see these projects and initiators as ‘one of them’, because of the shared ‘entrepreneurial activism’. For an outsider, the difference between both fades.

One of their conclusions was that there is a need for political activism by these bottom-up activists right now, rather than only acting boots on the ground. Otherwise real systemic change may not follow, as politics today is mainly politics for the sake of politics, heavily influenced by big economy.

What do you think about this?

I see similar things

I see people in today’s fairly young generations building professional paths along these lines. One of the latest political party in Romania running for national elections is a formerly local political party founded by civic activists. Now they’re going national, after the founder has seen 25% support in the local elections. However it looks like titanic work, their lack of experience shows many times, and funding missing. The road is uncertain, but attests to the idea above.

Also, my story of a grassroots innovation in the medical system which a few years later contributed to the founder being appointed Minister of Health also makes the case.

Interesting outcome

That’s an interesting development! Thanks for sharing.

I’m actually trying to send some medicines to a friend in Serbia at the moment, because he got the meds prescribed for Lyme but cannot buy them over there. It really doesn’t make any sense at all.

Aw :frowning:

Probably the easiest is to find a human carrier, you never know with medicine across borders.

Giving back to floor to those who act

@Noemi, My two cents about your questions. The ethical suffering can occur in any organization where it is required to do things that are too far from what actual work should look like in the eyes of the concerned people who are passionated about what they do.

I’ve observed such situations in not for profit AND in for profit organizations even though the purpose and the values behind the organization were sensefull for people. It is about the meaning of the work to be done and the way it is asked.

Indeed distributed decision making processes (cf the integrative decision making process), spaces where people can share practices in order to improve them (which supposes that they have an influence on them), the autonomy of each team and individual in his/her area of competence and responsibility (where each person is sometimes leader and sometimes follower) combined with a results-oriented work process (instead of an effort-oriented culture giving more credit on hours spent then on results) are cornerstones to move forward in the right direction.

What is meant by heath at work ? Do we speak about fitness, yoga and mindfulness ? If so, it is just an approach to relieve people and allow them to go on in an unsatisfactory environment. If it comes on top of the characteristics I mentioned hereabove, it will be the ice on the cake.

Last but not least, working for a purpose-led organization that strives for a better world will surely help at the condition that the way this organization works is consistent with its aspiration.

Discussing about “policy for opencare” tight now

Hello @Yannick , @Philippe_Drouillon , @WinniePoncelet . Just letting you know that @Rossana_Torri , @Franca and their colleagues of the City of Milano are considering creating a challenge on policy for opencare within this conversation we are having. They hope to report on some experiences they are having now in Milan and (hopefully) get feedback, both from their local community in Milan and from the more global conversation here. They are smart, well-meaning civil servants serving under relatively enlightened political leadership (though this is Italy, and government is quite fragile and operates under a lot of constraints). I have now pointed them to this thread, hopefully they will have something to say.

Open policy making process

Thanks @Alberto!! This story and comments are REALLY interesting, also as a starting point for our challenge and the discussion that we would like to share here. Starting from Ginette/@Yannick perspective that identify these 2 main forms of Care: 1. Care that cames from love and friendship: 2. All other forms need to be done by the Government.

So the problem of scalability. We are seeing in our City and in Edgeryders, a lot of interesting care projects, community driven, but the idea is that the role for Government is to guarantee the scalability.

What is the scalability?

In my opinion the scalability could be possible only if these new solutions, new approaches became part of an open policy making process.

So, in our case, the Local Administration has to became an observator, a facilitator of these initiatives, helping them to evaluate their own effectiveness and impact.

In our experiences we’re observing many interesting care projects that are developed by communities, using new approaches to care, involving new actors (makers, hackers…)

These experiences are helping us to change also our services directly, to manage our services in new ways, trying to recompose the fragmented network of Care.

I think that Government could be not an obstacle, or a part of the problem, risk that @winnieponcelet reported, but  (hopefully!!) a part of the solution: if tha PA can change its perspective and tries  not to be THE actor, the only care provider really allowed to do something, but one of the actors.

Also, maybe, to guarantee not to fall to a neoliberalism way to solve problems…

But in which role?

We’are thinking to develop this idea: became an enabling platform that can facilitate the dissemination of some solutions, and create the conditions to replicate in a large scale what has been evaluated effective.

But it’s not simple, and of course we’re talking in general.

We want to open a challenge about this topic because we would like to stimulate a debate and also find concrete examples about the role that in each project could/should be done by a Public Administration (in particular Municipalities).

We‘ll share also some stories of our administration that in our opinion are going in this direction, to rethink traditional services in the new context of Care.

This conversation could maybe became also a way to create a path for discussing how civil servants could continue to believe to do a “real work” and not just a prescribed, traditional work, @PhilippeDrouillon.

What do you think?

Meet Franca, everyone

Ping @Philippe_Drouillon | @Yannick | @WinniePoncelet

Everyone, meet @Franca . What she is not saying is that she is government, or, better, that she works for the Milan City Hall. I showed her Yannick’s post and your comments; it resonates with her and her colleagues, because, just as Yannick probably imagined when he first wrote the post, they crave this kind of frank-yet-constructive dialogue with citizens.

It would be interesting to challenge the opencare community to find actual policies of care that “give back the floor to those who act”, to use Philippe’s very nice phrasing. What do you guys think? How would you see it happening?

“We’are thinking to develop this idea: became an enabling platform that can facilitate the dissemination of some solutions, and create the conditions to replicate in a large scale what has been evaluated effective.”

From the perspective of our organisation, this is exactly what we need. We follow this strategy internally in our organisation as well: test lots of things in a small cheap way, evaluate, scale, evaluate and so on. In my city this is done sometimes, like with the Living Streets project. The city was cooperative enough to let them test the idea. These are exceptions sadly.

I’ve been to a few city organised or backed ‘workshops’ meant to shape the future of the city. The workshops all lack the same: citizens present. Generally, they are organised during working hours and the only participants are civil servants and companies/entrepreneurs that have an economic stake in the issue. The details of how these workshops go, are pathetic. And it’s packaged and sold to the citizens as ‘co-creation’. Last one was most striking. A workshop on urban planning, commissioned by the city and organised by the same organisations that were involved in an ongoing massive real estate scandal. The workshop itself featured only entrepreneurs and project developers, talking about matters that affect everyone. Already at this basic level, the city fails. How can anything good come from such a basis?

Maybe this is how at least a little good can come from it. Our city has an image of being progressive and there are lots of projects that prove this. In the end however, politicians mainly want to get re-elected or get a better position next term. This means they need to live up to public expectations and produce impact in the short term. The fact that people here expect politicians to be more progressive, means the politician’s output will have to be more progressive in order to make a career. As a result we have a pretty awesome city. However, it’s a sugary coating that hides the broken way in which we are governed.

I’ve been advised by a project coordinator to stay away from help from the city. She described it like this: if we were to receive support from the educational department under politician x from party a, next term all support could be gone under politician y from party b. Because politician y needs to have their own projects for their curriculum, so the limited means need to go towards launching new initiatives from scratch under their term. Also, draining a project from a political opponent diminishes that opponent’s credibility. This is such a waste on so many levels: money, knowledge, time, … Not to mention the competitive atmosphere this actually creates between projects that otherwise share a similar purpose.

My own experience: I contacted the city anyway a few months back. I mailed with the responsible politician and she directed me to the civil servant at the bottom of the ‘food chain’. We met, she was impressed by our project and clearly wanted to help. She promised me to take the message back up the food chain, but assured me it would take a while, and keep me updated along the way. The department got restructured, so this was slowing things down. Fast forward 2 months, no news, and our project is already in a different stage. Time flows differently for the government, I hope people age slower as a perk for working there.

A government platform for projects to grow at their own speed would be a major improvement. De-coupling this platform from political incentives is a priority.

Great to read this :slight_smile:

Hey @Franca and @WinniePoncelet thanks for these comments.

What you wrote Franca is really great to read, because it is the first time actually having a policy maker understanding so well the principle of an open care system, but also discribing the role a governement has to play in the futur. He is there as a facilitator, giving the right tools to test and later on help scale the bottom up initiatives. In such way the governement becomes a currator, not simply a gatekeeper of the funds, but the person who helps grow the talented projects.

Winnie i know what you are discribing, with my years of activism i had mostly the same kind of experience  with policy makers in Brussels. Getting funds is tricky because you need to behave a certain way because ‘they’ have the power in hand, you have to calculate who is going to get the portefieulle in next couple of years and so on.

But a couple of days ago a kind of epiphany came accross. In fact like what edgeryders does on care, we can create locally on any topic, creating an easy swarm of projects that can become a lever to not wait till policy is written, but to shape what it is going to be without having to play the political game. We are going to do this exercice with the Brussels makers scene through the FabCity platform of Barcelona. Bringing projects towards organisations and spaces and coordinating these spaces to communicate as one about their needs towards politics. In such way that we don’t have the proposal from politics: let’s just build 170 fablabs for 2020, but that through the swarm of knowledge know what are really the necesities.

Hope i could contribute to this nice debate;

Swarms are great! But…

I totally agree, @Yannick , we can do many things on our own. The “smart swarm” model we pioneered with Open&Change has a lot of potential and, like you say, it can be applied to mamy things beyond care. It is a potentially powerful tool.

But I would not underestimate policy. A determined policy maker can make stuff happen. In 2012, Milano invented a new policy that works like this: they put out a list of 100 entire buildings, and 1,000 smaller spaces, that the city owns. You can have one of them, for free and for up to 30 years, as long as you (1) fix it and maintain it with your own money and (2) use it for activities that have social benefits. The city is being quite proactive: in one neighborhood it might encourage activities that interest young people, in another the focus might be on migrants etc. (see here, in Italian). It’s the same thing you are doing at VDH, Yannick, but on a much larger scale.

I, for one, am very interested in having a discussion on policy with you guys. I would be more than willing to reach out to other policy makers too. What do you think?


Hi @WinniePoncelet, “A government platform for projects to grow at their own speed would be a major improvement. De-coupling this platform from political incentives is a priority.”


in my opinion you have touched a key point. When you work in a public administration the relation between technicians and politicians are crucial, in particular if you want to do something, if you want really realize new and innovative projects. In many situations for example the fact that a politician is engaged in a project became the only possibility to realize the projects.


In many situations I saw terrible fights ‘politicians versus technicians’, but also collaborative approach, with a sharing of knowledge, working together for the same objectives.


Also the project of @Yannick seems very interesting and I would like to know more… could you give us more details?

As we announced we launched a challenge.

Could you read it and tell us if you think it’s interesting written in this way or if you want to change something… Every your suggestion will be precious!!!


Now we are starting to disseminate the challenge among some local partners, NGOs, associations that are working with us, but also among other local italian municipalities.


Could you help us to engage other political actors, as @Alberto suggested??


It could be really great and potentially of huge impact… what do you think??



@Franca I think having this conversation is a great first step. It’s going to be a very complex problem to solve. Its tentacles go so far into other domains that are even more fundamental to our society.

When we set out to solve a complex problem in our organisation, we start with small actions that change the context a little. Small experiments that can fail, but the lessons of which can scale big. A great example in government is a challenge this month of my own city where they will distribute 1,300,000 euros among civilian projects that aim to have a positive impact on the city. Citizen vote will account for 70% in the decision where the money goes. I don’t think popularity contests are the best way to do this either, but it’s a beginning and will change the playing field.

Yet this is already at the interface with the public, at the policy level. Most possible small experiments I can think of would all very likely fail at another point: the government itself. The processes, people, time perception, incentive structures, … Seperately these things are not huge problems, but together they form a problem where there are little starting points to start solving it. I’d say the most important problem for the government to solve today, is the government itself, not the policies it produces. So we need small actions in that aspect, eg. hiring a few recruiters that recognise the skills needed to implement change. And then you can sustainably keep producing good policy, even parallel while changing the internals.

Low level rules are the most important

@WinniePoncelet I completely agree with your point of view. The political process (and media) focus on high-level strategies, but the greatest impact reforms would come from reforming the govt’s operating system: quite simply, the affordances of people therein. Example: my sister works for an Italian municipality called Modena. In a drive to contain costs, some genius passed an internal regulation that employees travelling on business (“missions”, as they are known in the public sector) need an authorization from the highest political level (giunta in Italian, which means the mayor and her close collaborators). This is such a hassle that in 99.9% of the cases managers renounce. Employees do not get to go to conferences. As a result, over time the whole workforce becomes isolated and its skillset depreciates and withers.

Changing this does not require a strategy. A workforce that stays up to date would help any mayor, be she conservative or progressive. It does not require changing the law, either. The city council could simply vote a resolution allocating a modest budget that each employee can use to go to conferences and events they are interested in. This would have a massive impact, in my opinion. Maybe @Franca has an idea of how these decisions are made (or, in the case of Modena, not made).

Nice example

@Alberto That is a beautiful example of this harmful shift towards ‘control’ and ‘planning’, inspired by uncertainty and distrust, while we should be shifting towards a dynamic interplay between ‘noticing’ and ‘steering’, inspired by best estimates and trust.

I do think that institutions and companies are (perhaps unknowingly) looking for these qualities when you see trends in expectations set by job offerings, although they use different words. Yet ironically, those companies and institutions seem to lack the ‘noticing’ and ‘steering’ qualities to realise what they are actually looking for and thus be good at recruiting the people who have what it takes.

You have a good point about isolation and depreciation of skill sets. Keeping your workforce up to date entails both education and turnover.

A new point of view perhaps?

Hi everyone, this is to introduce @mariam1313 and also draw her attention to this conversation. She’s working in Georgian public sector in areas of innovation. Mariam can we quickly pick your brains on this? Above Franca (Milano), Yannick (Brussels), Winnie (Ghent) and Alberto whom you know are sharing experiences about what it takes for accountable and efficient gov programming to happen in order to better support citizens and initiatives. Franca (working on the inside of the system) said that the public administration needs to learn to become a facilitator and enabler of solutions, not necessarily THE solution provider which fails in so many cases. Do you have an example of good governance from your office? Or healthy collaboration between policy makers and technicians/ citizen experts/ creative people etc? Thanks, and officially: welcome on the platform!