In this book, Cottam asserts that the 20th-century welfare state-born from the Beveridge model-is now overwhelmed by modern challenges like chronic illness, precarious work, isolation, obesity, and aging, and operates more like a costly, bureaucratic “management-state” than a tool for human flourishing. She argues that true transformation requires decentring impersonal, risk-management institutions and instead fostering human relationships, local community design, and participants’ capabilities and aspirations.
Drawing from five real-world pilots conducted through her organization Participle, Cottam highlights practical “radical inversions”-from family-led support teams in Swindon, youth internship networks, peer support in employment schemes, personalized health outreach to chronically ill individuals, and elderly social “Circle” cooperatives. These programs prioritize active listening, shared decision-making (e.g., clients interviewing their own support teams), and human-first design, supported-but not replaced-by digital tools, reinvesting scarce resources into connection and purpose rather than service delivery. Cottam proposes scaling not through industrial rollout, but by seeding adaptable, locally rooted models tied together by shared values-cultivating distributed growth rather than central mandates.