For 'service user inclusion' read 'service user protest'

By Peter Beresford

For more than 20 years now, user involvement has been the mantra in social work and social care. Since the Children Act and the NHS and Community Care Act, we've grown accustomed to a whole new rhetoric of "consumer engagement", "public, patient involvement" and "customer voice". It has increasingly spread across the gamut of public services, from health to housing, education to recreation. It sometimes feels, as a service user, that you can't move for consultations, listening exercises and questionnaire surveys.

But as the government embarks on yet another national consultation on the future of social care prior to the publication of its Spring White Paper, is it perhaps time to say enough? Has user involvement effectively had its day? Is it really now dead in the water? Service users have long been talking about "consultation fatigue", highlighting how little gain there can be for much pain, answering official questions. What, they say, have we got to show for endless invitations to become involved and enormous effort providing feedback? "Not a lot", is often the answer.

But much more fundamental questions are now being raised. Massive cuts in dedicated social care and local services more generally, are hitting disabled people and other service users. Service users and other community groups have found that the argument that these cuts may end up costing more has been ignored.

According to government, all is being done in the name of public deficit reduction and no human need or disability right seems to count for much stacked against this over-riding goal. This has perhaps found its most brutal expression in relation to welfare benefits - which again hit social care service users hardest. Arbitrary and inaccurate assessment and review processes as well as harsh cuts in entitlement, are being used to force people off welfare regardless. Service users' views on the matter are neither seriously sought nor listened to.
Service users and their allies, however, have skilfully adopted another approach, using all the paraphernalia of 21st century technology and social networking. They may not be feeding in their views as they were once asked, but they are certainly making their voices heard - through demonstrations and direct action, through collective action and organised marches, nationally and locally.

They are using all the apparatus of local and national democracy - pressing their councillors, calling in favours from their MPs. They are seeking and obtaining judicial reviews where arbitrary cuts are being made and their lives, livelihoods and well-being put at risk.  
User involvement is dead. Long live user involvement.

Peter Beresford is professor of social policy at Brunel University and is active in the service user movement