The Simon Heng column

Not so long ago, service users like myself were campaigning to be
involved in decision-making: we felt that we needed to push hard to
be involved in planning, monitoring, recruitment and selection and

Among the growth areas are more in-service training and social work
and nursing education. In the past year, I have been involved in
piloting at least three training packages for social and health
care workers and service users themselves which have required
clients to be part of the training team. I have also taken part in
initiatives to involve service users as educators on vocational
social work and nursing training courses.

In the days when service-user representation was tokenistic, there
was a standing joke that, if service-user views were needed, the
usual suspects had to be rounded up. There was a small number of
people willing to give up their time to represent all service
users. Although organisations have tried to enable more people to
become actively involved, the number of us who feel confident to
confront the professionals is still small – despite the best
efforts of everyone involved in inclusion.

So, there is a growing awareness that many service users will not
be constantly, actively involved, through lack of time, inclination
or energy. Apart from anything else, they wouldn’t be service users
unless they were chronically sick or disabled. This has led to new
ways of gathering people’s opinions: surveys, interviews, even
video. But the usual suspects still find themselves invited to
participate in an ever-expanding round of meetings and initiatives.

For all the discussion about rewarding people for their time and
effort, no one has resolved the (contradictory) difficulties for
service users who become actively involved: virtually all of us are
dependent on benefits, which allows little scope for financial
Moreover, there is a risk that this group of people will become
detached from the usual service-user experience, becoming
professionalised service users, with the risk that they cease to be
representative – or just burn out.

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