Marian Barnes

Power, participation and political renewal: Case studies in public participation

Introduction Participation in context Inclusive democracy and social movements Shaping public participation: public bodies and their publics Re-forming services Neighbourhood and community governance Responding to a differentiated public Issues and expertise Conclusion: power, participation and political renewal.

Users as citizens: collective action and the local governance of welfare

Self-organization amongst users of community care services preceded the consumerist developments of the 1980s and early 1990s, but can be considered to have been ‘‘legitimized’’ by top-down objectives relating to ‘‘user involvement’’. Nevertheless, the objectives and value bases of disabled people’s organizations and organizations of users (or survivors) of mental health services have not always been consistent with those of consumerism, and user groups have experienced tensions in determining the extent to which they should respond to official agendas. Drawing on theories of new social movements and of citizenship, this paper considers the developing place of user organizations within systems of local governance. It looks at the way in which groups have sought to assert the legitimacy both of experiential knowledge and of their position as citizens in the face of official responses which have constructed them as self-interested pressure groups. It draws on empirical research investigating local groups of disabled people and of mental health service users conducted in the first part of the 1990s. It discusses the significance of shared identity as a basis for collective action alongside more pragmatic motivations to influence the nature of health and social care services. In the context of appeals to ‘‘community’’ and ‘‘partnership’’ which are starting to replace the discourse of markets and contracts as the key metaphor for both policy-making and service delivery, the article considers likely future roles for groups comprising people often excluded from community.

Care in everyday life : an ethic of care in practice

This book argues for the importance of care as a value and practice across a range of contexts and relationships. It applies an analysis based in a feminist ethics of care to circumstances in which care has typically been recognised as a key value: eg care for children, for people who are ill or frail, and to circumstance in which its relevance is more rarely considered, eg friendship relationships and stranger relationships. It identifies the significance of care in the context of politics and policy making and offers an imaginary of a social policy based more firmly than is currently the case in political and personal values of care This book addresses care as a practice, a disposition, and a moral, social and political value essential to our capacity to live well together, and to ensure proper treatment for those most likely to experience marginalisation and exclusion. Care has been devalued in contemporary social policy in favour of a rather different set of values – those associated with choice and control. At the same time, both the concept and practice of care within social policy has been stimulated by the work of political philosophers (eg Tronto, 1993, Sevenhuijsen, 1998) who have argued for the necessity of care to social justice. This book challenges the assertion that care is ‘past its sell by date’ (Beresford, 2008). It addresses academics and practitioners who seek to contribute to the development of policies and practices that can enable people to live well together.

Passionate participation: emotional experiences and expressions in deliberative forums

This article explores the emotional dimension of public participation. It contrasts the understanding of deliberative forums as spaces in which reasoned argument is intended to lead to good policy making, with the importance of values and emotions in motivating action within social movements. In the context of a widening of the participatory sphere and the increasing likelihood that social movement activists will also take part in officially sponsored participation initiatives, it considers the significance of the emotional content of experiences that service users and citizens bring to discussions about policy and service delivery. Drawing on a feminist ethic of care it suggests criteria for assessing the capacity of deliberative practices to encompass an emotional morality and to deliver on aspirations for enhanced well-being, welfare and social justice.

The same old process? Older people, participation and deliberation

Opportunities for older people to take part in decision making about public policies and services are expanding in the United Kingdom and elsewhere. This paper considers the potential of older peoples participation in policy processes for both transforming the policy process and for achieving socially just outcomes. It argues that the way in which such participation takes place, in particular the nature of the deliberative processes, affects both who will feel able to take part and the capacity to develop new policy discourses which can challenge official perspectives and assumptions. It draws from critical perspectives on deliberative democracy to provide a theoretical framework. This work emphasises the importance of story telling and forms of exchange designed to offer recognition to others, as well as the rational argument more usually associated with deliberation on matters of public policy. The argument is illustrated with examples of participation initiatives that have involved ‘active’ older people and those who are users of social care services. Different styles and processes of exchange are distinguished in the three case studies. In one, active facilitation enables individual stories of ageing and of service use to be woven into collective narratives that offer an alternative vision of care services. In another, a strong emphasis on ‘greeting’ enables conflicting views to be expressed without participants falling out. In the third, styles of exchange familiar in formal debate limit the development of an alternative discourse. The conclusion suggests that attention needs to be given to the process of participation as well as to outcomes.

Spoilt for choice? How consumerism can disempower public service users

The determination to increase individual choice lies at the heart of the Governments public service reforms and its strategy for empowering citizens as consumers. This article, informed by recent sociological discussions of the characteristics of contemporary social life, suggests that prioritizing individual choice can have disempowering consequences for public service users, generating confusion, uncertainty and stress. A better alternative would be to develop means of strengthening users’ influence over the shape and content of services.

Learning to hear voices: Listening to users of mental health services

This article reports findings from a Users Councils project developed as part of a multi-dimensional approach to the development of user-led community care services: the Birmingham Community Care Special Action Project (CCSAP). The evaluation of the user involvement dimension of CCSAP sought to answer three basic questions: Who was involved? How were they involved? What were the outcomes of involvement? This article highlights the particular significance of enabling users of mental health services to express a ‘voice’ which is recognized as valid by those professionally involved with their care. It identifies the different motivations and purposes which encourage users to become involved in user councils and emphasises the need for clarity and openness about the objectives to be achieved. It considers provider responses to those voices and discusses the importance of establishing means through which voice can be translated into action by those with responsibilities for services.

Promoting Social Change: The Experience of Health Action Zones in England

When New Labour came to power in the UK in1997 it brought with it a strong commitment to reducing inequality and social exclusion. One strand of its strategy involved a focus on areabased initiatives to reduce the effects of persistent disadvantage. Health Action Zones (HAZs) were the first example of this type of intervention, and their focus on community-based initiatives to tackle the wider social determinants of health inequalities excited great interest both nationally and internationally. This article draws on findings from the national evaluation of the initiative. It provides an overview of the HAZ experience, and explores why many of the great expectations associated with HAZs at their launch failed to materialise. It suggests that, despite their relatively limited impact, it is best to consider that they made a good start in difficult circumstances rather than that they failed. As a result there are some important lessons to be learned about the role of complex community-based interventions in tackling seemingly intractable social problems for policy-makers, practitioners and evaluators.

Critical Perspectives on User Involvement

Drawing on contributions from user activists and academic researchers, this topical reader provides a critical stock take of the state of user involvement. It considers different contexts in which such involvement is taking place and includes diverse and sometimes conflicting perspectives on the issues involved. This original and insightful critique will be an important resource for students studying health and social care and social work, researchers and user activists.

Abandoning Care? A Critical Perspective on Personalisation from an Ethic of Care

The adoption of personalisation as the principle on which policy and practices for social care in England should be developed has been hailed as marking a fundamental transformation in the nature of social care and the experiences of service users. This article examines both the discourse of personalisation and the practices that are being adopted to implement this from an ethic of care perspective. It adopts an approach based on Sevenhuijsens ‘Trace’ analysis to trace the normative frameworks in key policy documents (in particular Putting People First), noting that critics of care have largely succeeded in relegating care to a marginal position within policy discourse and that a relational sensibility is largely absent within this. The article considers the practices associated with personalisation in relation to the moral principles of an ethic of care and conceptions of the ‘individual’ within these. It addresses the implications of this approach for broader political and policy issues: the universality of provision, collective responsibility for welfare and well-being, and broader issues of social justice in conditions of vulnerability.