The emphasis on public participation in contemporary policy discourse has prompted the development of a wide range of forums within which dialogue takes place between citizens and officials. Often such initiatives are intended to contribute to objectives relating to social exclusion and democratic renewal. The question of ‘who takes part’ within such forums is, then, critical to an understanding of how far new types of forums can contribute to the delivery of such objectives. This article draws on early findings of research conducted as part of the ESRC Democracy and Participation Programme. It addresses three questions: ‘How do public bodies define or constitute the public that they wish to engage in dialogue?’; ‘What notions of representation or representativeness do participants and public officials bring to the idea of legitimate membership of such forums?’; and ‘How do deliberative forums contribute to, or help ameliorate, processes of social inclusion and exclusion?’
This paper draws on the findings of a study within the ESRC's Democracy and Participation Programme. It explores the processes of participation within deliberative forums -such as user panels, youth forums, area based committees -developed as a means of encouraging a more active, participating mode of citizenship and of improving welfare services by making them more responsive to users. Our findings open up a number of issues about constraints on the development of 'collaborative governance'. To understand these constraints, we suggest, there is need to locate participation initiatives in the context of government policy, to explore ways in which such policy is interpreted and enacted by strategic actors in local organisations and to examine the perceptions of members of deliberative forums themselves. Our findings highlight the constraints on the 'political opportunity structures' created by the enhanced policy focus on public participation, and the consequent limits to 'collaborative governance'. We discuss how governance theory and social movement theory can each contribute to the analysis, but also suggest productive points of engagement through which each of these bodies of theory might enrich the other.
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 of®cial 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 of®cial 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 ®rst part of the 1990s. It discusses the signi®cance of shared identity as a basis for collective action alongside more pragmatic motivations to in¯uence 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.
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.
BackgroundOver the last 20 years governments around the world have promoted user involvement in an effort to improve the quality of health services. Despite the growing emphasis placed on user involvement in England, there is a paucity of recent studies looking at how service users and professionals perceive the outcomes of user involvement policies. This study aimed to examine the overall levels of participation in service user involvement in mental health services among professionals and service users and ascertain their views on the impact of involvement activity on various areas of service delivery.MethodsA cross-sectional survey of service users and providers within community mental health services. The sampling was carried out across three mental health Trusts, two serving people living in inner-city areas and a third covering a mixed rural/urban population. A questionnaire with closed and open ended questions was used to gather the responses of service users and frontline professionals. As a mixed methods study, the analysis consisted of both quantitative and qualitative approaches.ResultsThree hundred and two service users responded to the survey with a response rate of 48%. One hundred and forty three frontline mental health professionals, 26.8% of those approached submitted questionnaires. Almost half of service users (N=138, 45.7%,) and healthcare professionals (N=143, 55.9%) reported having been involved in some form of user involvement activity. Although there were some differences in the responses of service users and frontline professionals, both groups reported that service user involvement was having a positive impact.ConclusionsThe findings show that, within the three mental health trusts examined in this study, service user involvement has become widespread and is perceived by both staff and service users to be a good policy. The study had some important limitations. The questionnaire used was based on existing literature, however it was not subjected to psychometric testing. In addition, response rates were low, particularly among professionals. Despite the limitations, the findings are encouraging, offering important of insight into views and experiences of service users and healthcare staff. Further studies are needed to assess and investigate the topic on a national level.
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 people's 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.
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