Introduction

Most of the advocacy funded by the state is always likely to be focused on individuals dealing with one-off problems. But collective advocacy by groups of service users must continue alongside this work.

Individual advocacy can help people cope a bit better with the world they live in. But it never reaches some of those who most need this help. And it may too easily reinforce the assumption – encouraged by much government policy – that each of us has to fight our own corner in the public services market place to get the best deal we can in competition with every other ‘customer’. It is only when people who share similar experiences of the public services get together that they can start thinking seriously about changes that may be needed and pressing for action to bring those changes about. As voters and taxpayers speaking for many others whose expertise has been gained from experience of these services, they can in time wield considerable influence. Then things can be improved for everyone – including those who have never met an advocate.

Groups form for all sorts of good reasons – therapeutic, educational, or simply as supportive clubs of friends. This chapter deals with groups that help their members and others like themselves to get the help and treatment they should be entitled to and to bring about improvements in the services they all depend on. While they may do other things too, it is their advocacy we shall focus on, relying on Scottish examples because there is much innovative work of this kind going on here. We describe groups known to us that are doing interesting things, without claiming that these give a comprehensive or typical picture of what is happening in this country.

People in these groups are embedded in various ways in the communities from which their members are drawn. That community may be the staff and patients in a hospital, or just one hospital ward; they may be the people using a day centre, or anyone with mental health or learning difficulties who lives in a particular neighbourhood or city. To bring about change the group will have to influence other people in these communities – doctors, health service managers, politicians and the various ‘publics’ to which these people respond.