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A paradox in healthcare service development: Professionalization of service users

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  • El Enany, Nellie
  • Currie, Graeme
  • Lockett, Andy

Abstract

Policy makers increasingly regard user involvement as an important dimension of service development. However, research suggests user involvement is often unrepresentative and tokenistic. Drawing on an in-depth case study in mental health carried out in 2008–2012, we examine the processes that give rise to unrepresentative service user involvement. We show that through a combination of self-selection by those wanting to be involved, and professionals actively selecting, educating and socializing certain users, unrepresentative involvement occurs. The selected users tend to be more articulate and able to work with professionals, and are complicit in the processes which give rise to unrepresentative involvement. They pursue their own professional status by delineating a distinctive body of ‘expert’ management knowledge that bounds their jurisdiction, and from which they can exclude those they perceive as ‘less expert’ users.

Suggested Citation

  • El Enany, Nellie & Currie, Graeme & Lockett, Andy, 2013. "A paradox in healthcare service development: Professionalization of service users," Social Science & Medicine, Elsevier, vol. 80(C), pages 24-30.
    • Handle: RePEc:eee:socmed:v:80:y:2013:i:c:p:24-30
    DOI: 10.1016/j.socscimed.2013.01.004
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    References listed on IDEAS

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    1. Abelson, Julia & Forest, Pierre-Gerlier & Eyles, John & Smith, Patricia & Martin, Elisabeth & Gauvin, Francois-Pierre, 2003. "Deliberations about deliberative methods: issues in the design and evaluation of public participation processes," Social Science & Medicine, Elsevier, vol. 57(2), pages 239-251, July.
    2. Martin, Graham P., 2008. "Representativeness, legitimacy and power in public involvement in health-service management," Social Science & Medicine, Elsevier, vol. 67(11), pages 1757-1765, December.
    3. Ziebland, Sue, 2004. "The importance of being expert: the quest for cancer information on the Internet," Social Science & Medicine, Elsevier, vol. 59(9), pages 1783-1793, November.
    4. Contandriopoulos, Damien, 2004. "A sociological perspective on public participation in health care," Social Science & Medicine, Elsevier, vol. 58(2), pages 321-330, January.
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    Cited by:

    1. Mayara Ramos & Fernando A. Forcellini & Marcelo G. G. Ferreira & Simon Bowen & Peter C. Wright, 2022. "Cyclical experience‐based design: A proposal for engaging stakeholders in a co‐creative model for primary health care service design," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 486-503, January.
    2. Croft, Charlotte & Currie, Graeme & Staniszewska, Sophie, 2016. "Moving from rational to normative ideologies of control over public involvement: A case of continued managerial dominance," Social Science & Medicine, Elsevier, vol. 162(C), pages 124-132.
    3. Emil Lucian Crișan, 2022. "Reflections on New Service Development in Healthcare Industry," REVISTA DE MANAGEMENT COMPARAT INTERNATIONAL/REVIEW OF INTERNATIONAL COMPARATIVE MANAGEMENT, Faculty of Management, Academy of Economic Studies, Bucharest, Romania, vol. 23(1), pages 37-45, March.
    4. Adams, Wallis E., 2020. "Unintended consequences of institutionalizing peer support work in mental healthcare," Social Science & Medicine, Elsevier, vol. 262(C).
    5. de Freitas, Cláudia & Martin, Graham, 2015. "Inclusive public participation in health: Policy, practice and theoretical contributions to promote the involvement of marginalised groups in healthcare," Social Science & Medicine, Elsevier, vol. 135(C), pages 31-39.
    6. Glimmerveen, Ludo & Ybema, Sierk & Nies, Henk, 2018. "Empowering citizens or mining resources? The contested domain of citizen engagement in professional care services," Social Science & Medicine, Elsevier, vol. 203(C), pages 1-8.
    7. Brad Wright, 2015. "Voices of the Vulnerable: Community health centres and the promise and peril of consumer governance," Public Management Review, Taylor & Francis Journals, vol. 17(1), pages 57-71, January.

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