The ‘Empowerment Debate’: Consumerist, Professional and Liberational Perspectives in Health and Social Care

Abstract

This article aims to clarify the meaning of the much-used term 'empowerment' in order to contribute to a more theoretically coherent development of policy and practice aimed at facilitating the empowerment of health and social care service users. The liberational and consumerist models of empowerment are highlighted, with the former having a broader emphasis on people's roles within society than the latter. The concept of 'empowerment as professional practice' is also critically explored, with the conclusion that professionals can work with people in empowering ways if they recognise and work to address the structural causes of oppression.

Developing a ‘critical’ approach to patient and public involvement in patient safety in the NHS: learning lessons from other parts of the public sector?

“…In relation to different models of empowerment, Starkey,50 work, 51 has argued that a consumerist model of empowerment is likely to be less relevant in changing peopleÕs lives than a liberational model. This is because it focuses on people having to make choices within predetermined service systems defined by service providers and policy makers.…”

“…This is because it focuses on people having to make choices within predetermined service systems defined by service providers and policy makers. 50 Within the democratic ⁄ liberationist approach, Starkey drawing upon Barnes 52 notes that empowerment requires change to take place within individuals, as well as broader social systems and services, to support the participation of those previously excluded. 50 In practice, Tritter and McCallum 28 have attempted to broaden the theoretical debate about consumerist ⁄ managerialist approaches by defining PPI in more detail.…”

“…50 Within the democratic ⁄ liberationist approach, Starkey drawing upon Barnes 52 notes that empowerment requires change to take place within individuals, as well as broader social systems and services, to support the participation of those previously excluded. 50 In practice, Tritter and McCallum 28 have attempted to broaden the theoretical debate about consumerist ⁄ managerialist approaches by defining PPI in more detail. They argue PPI covers a spectrum of activities related to treatment decision making, service evaluation, service development, education and training and research.…”

Civicness in the governance and delivery of social services

“…In fact, the notion of giving the individual what (s)he wanted, abandons the educative approach always linked with public services that are meant to be equal for all but as well to make their addressees more equal. The various meanings of empowerment shifted from issues of 'voice' to issues of 'choice'; they now range from giving a group more specifically what it wants or needs to "making the customer satisfied" (Starkey 2003). If a school system, for example, is to be made more responsive to individual talents, preferences and needs, then why not give parents more choice over the educational facility and arrangements to be used?…”

Application du concept de responsabilisation personnelle aux usages sociaux des technologies d’information et de communication en santé

“…Pour mieux circonscrire ce concept, les chercheurs ont le plus souvent adopté une définition conforme au paradigme dans lequel se situaient leurs travaux. Le problème, qui est particulièrement apparent lorsqu'il s'agit d'analyser les usages sociaux des TIC, est que plusieurs logiques d'action peuvent influencer le développement de la responsabilisation personnelle dans le champ de la santé (Starkey, 2003).…”