Vanier's description of unintended consequences suggests mystery in the impetus to build collectively, and bafflement at the dysfunctional results. In a similar vein, Ivan Illich took the concept of iatrogenesis, the illness inadvertently caused by the intervention of a doctor, and applied it to public services (Illich, 1974); an idea developed by John McKnight (1995), who used the metaphor of the mechanised John Deere plough turning land, fertile when farmed less intensively by Native Americans, into a dust bowl. So, for McKnight, the overdevelopment of the profession of bereavement counsellor fosters the idea that grief is unhealthy and unmanageable by non-professionals. Grief, which was previously a ‘common property’ of the community – a shared responsibility to which family, friends and neighbours would respond – has become the exclusive professional domain of experts who are licensed and funded to assist the individual to process it:

By extension, any public service that operates in an area of life that was previously the domain of ordinary family or community relationships risks ‘colonising’ that area of life, creating ‘careless societies’ with clients rather than citizens, who lack confidence in their ability to care for themselves and each other.

McKnight's ideas have not taken hold among UK service planners or policy makers. They are deeply uncomfortable for those who do not wish to think of themselves as doing more harm than good with the resources they control, but also for activists and people who rely on services for vital support and feel those services are increasingly attacked and cut.