2: Whose views, and lives, truly count? The meaning of co-production against a background of worsening inequalities
Amidst the suffering caused by the COVID-19 pandemic in the UK and beyond, serious questions have arisen about social systems and persistent, sometimes worsening, inequalities. While there have also been many instances of cooperation and mutual care, those already facing disadvantage and discrimination have been among the worst-hit and deep divisions within society have surfaced. These differences in power, experience, and whose lives are truly valued, should not be ignored.
This context is relevant to co-production in health and social care practice, policy, and research, which involves working together for common goals and equal sharing of power. Often the focus of what is written about this subject is on bridging the gap between, on the one hand, public sector staff or researchers and, on the other hand, service users, carers, or other members of the public. Sometimes, if the latter are from often-marginalised groups, this imbalance in power and status is seen as being even greater. While these gaps are indeed important, a broader perspective can deepen understanding of what helps or hinders co-production.
Various developments in the years leading up to the pandemic shaped the realities surrounding frontline health and care workers, those they served, carers, communities, and research teams, with effects on their relationships and capacity for cooperation. This chapter looks most closely at what happened in England, since national governments elsewhere in the UK, have sometimes adopted different policies, though some of the issues touched on here have far wider relevance. What I write here, amidst a ‘second wave’, is neither complete nor impartial.
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