27 Critical Soc. Pol'y 5 (2007)

handle is hein.journals/critsplcy27 and id is 1 raw text is: 




J   STEPHEN COWDEN & GURNAM SINGH
    Coventry University


    The  'User':   Friend,  foe  or fetish?  A  critical
    exploration of user involvement in health and

    social  care



    Abstract
    'User Involvement' has become the new mantra in Public Services with
    professionals constantly being reminded that 'user knows best'. The pur-
    pose of this paper is to ask where the preoccupation with 'the User'
    comes from and  to pose some questions about what 'User Involvement'
    actually means. Within our paper we see three issues as central within
    this. The first is a consideration of the historical antecedents of the dis-
    course of 'User Involvement', focusing in on the struggles over British
    welfare that took place around the late 1970s-early 1980s. This forms
    the context from which  we seek to understand and critique the New
    Labour project in relation to the massive expansion of regulatory frame-
    works. We  argue that, far from enabling the delivery of high quality
    integrated services that truly reflect the interests of current and future
    users, these policies represent the further commodification of basic
    human  needs and welfare. Finally, it has become apparent the current
    'User' discourse has assumed contradictory manifestations, in particular
    the emergence  of groupings of 'professional users' who participate in
    the formation of state policy as 'expert consultants'. We conclude by
    arguing for an approach in which user perspectives are neither privileged
    nor subjugated, but are situated in a process of creative critical dialogue
    with professionals, which is linked to the development of a concept of
    welfare driven by emancipatory rather than regulatory imperatives.

    Key  words:   empowerment,   ideology, user, user involvement



Introduction

    I am  personally suspicious of a monolithic approach to user involve-
    ment  . . . we need to consider user involvement . . . more carefully and


Copyright  2007 CriticalSocial Policy Ltd 0261-0183 86 Vol. 27(1): 5-23; 072205
SAGE PUBLICATIONS (London, Thousand Oaks, CA and New Delhi), 10.1177/0261018307072205


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