Partnerships, Power and the “New” Politics of Community Participation in British Health Care

Abstract

Multi-sectoral approaches to health improvement in its broadest sense have entailed an emphasis by the British government upon partnership working in and around community involvement in planning processes. New service planning and delivery organizations in the health serviceprimary care groups and primary care trusts-thus have to ensure that public and patient involvement strategies reflect a coordinated, if not integrated, multi-sectoral approach to such involvement. But how are these enforced partnership arrangements shaping the approach taken by primary care groups and trusts to the issue of public and patient involvement? More particularly, is the traditional dominance of health service managers and the medical profession in decisionmaking processes under challenge? This article draws on a study of primary care groups and trusts in three districts in order to gauge perceptions and calculations with regard to partnerships for involvement. Results appear to suggest that health service managers and practitioners continue to exercise considerable influence in comparison to that of patients and citizens. But, if the findings are viewed in the broader contexts of government managerialist strategies of surveillance and accountability and the growth of service-user and advocacy organizations, partnerships may offer significant scope for "lay" challenges to managerial and medical power.

Understanding the factors that make public participation effective in health policy and planning: a realist synthesis

“…This is consistent with the observation made by Crawford et al (2003) on the central role that managers and staff play in determining the effect of public participation exercise. It indicates that in achieving various public participation effectiveness, it is imperative to consider the critical role of public participation sponsors and public officials (Abelson and Gauvin 2006), especially that ultimately, the policymakers will decide whether to incorporate the public inputs in policy decisions (Milewa et al 2002). Further, as the mechanism of political commitment primarily focuses on public officials, this review finding is relevant to the observation of Boswell et al (2015), whereby 'invited' spaces, or those state-initiated arenas for public participation, have more direct effect or influence on policy decisions and decision-making processes compared to those participation spaces in which the citizens created themselves -or the so-called 'invented' spaces.…”

Developing consumer-directed care for people with a disability: 10 lessons for user participation in health and community care policy and program development

“…5 Still, until the mid 1990s, projects that draw on the preferences of end users to determine policy options remained confined to the realm of experimentation. 4,5,11,12,[15][16][17][18] More recently, however, policy makers in Europe and North America have embraced consumer choice as a key criterion to make health and social care service more flexible and responsive. [19][20][21] As a result, user involvement has been mainstreamed and many of the governance structures within the administration of health and social care have been replaced by programmatic approaches that transfer to users more direct control over the services they receive.…”

Partnerships, community groups and social inclusion

“…In contrast, research into partnerships between local community groups and a variety of public and private sector organisations (e.g. Hatcher and Leblond, 2001;Huxham and Vangen, 2000, a, b;Milewa et al, 2002;Tett et al, 2003) shows the conflictual character of coordinating different and unequal interest and identity groups. Different partners bring differential forms of power and some have greater control over the change process as a result.…”