Introduction

This chapter differs somewhat in focus from others in this part of the collection. It does not directly examine disciplinary strategies or appraise incentivisation and nudge tactics (see Chapter Nine). Instead, discussion centres around the involvement and participation of service users. Encouraging people to participate and give their views is very different from disciplining them, even though it too connects with how government wants target groups to act. Indeed, systematic involvement of service users and the ‘subjects’ of social policy can potentially offer something positive to set against the march towards greater coercion in welfare systems, and remains potentially crucial to challenging powerful state organisations and private companies. Even in the context of participation exercises, however, there may be official expectations for preferred behaviours to assist services management, while the theme of responsibilisation sometimes runs as an undercurrent within the flow of involvement practices.

The concept of ‘user involvement’ has been an important area of interest for politicians and decision makers over several decades. Although the concept lacks an agreed and universal definition, the aims and values attached to the process have generally related to issues of power and control. Political discourse around the topic has drawn on a variety of powerful ‘soundbites’: enhancing choice, removing dependency, modernising government, renewing democracy and reinforcing the ‘Big Society’. The end product of political interventions here – which have straddled some 30 years over the tenure of five Prime Ministers of both the Left and Right – has been a reinforcement of the roles of the users of public services in their relationships with the state. This has been engineered at three overlapping levels:

• • a collective level, through the encouragement for instance of the user voice in the commissioning and provision of health and social care services using Patient Panels, pensioner forums and the like;

• • a community level, through the community development programmes of the 1970s, the neighbourhood renewal initiatives of New Labour and more recently the coalition government's promotion of Community Challenge contained in the Localism Act 2011;

• • an individual level, as with the regular exhortations for patient-centred care in the NHS, the development of a consumerist dialogue and the ‘personalisation’ agenda, and the growth of ‘direct payments’ and the right to choose, which became embedded in some practices of social care authorities.