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  • Author or Editor: Sarah Carr x
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This chapter explores the idea of using personal narrative and testimony to contribute to collective knowledge on lesbian, gay and bisexual (LGB) experiences of mental distress and mental health service use. It draws upon some personal reflections about the methodologies previously used by the writer, particularly where personal experience is included both as a starting point and as a form of inquiry and then located individual narrative as part of collective user and survivor knowledge. The exploration attempts to situate this approach within the wider tradition of the use of experiential knowledge, narrative and testimony in user and survivor research. It also links the use of personal narrative to the development of individual and collective identity for LGB people. Finally the potential of auto-ethnography to provide a viable methodology for capturing personal testimony, experience and narrative for user and survivor research, particularly that by LGB people, is discussed.

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This chapter is a critical examination of the core government personalisation policy documents – Putting People First (DH, 2007) and Think Local, Act Personal (TLAP, 2011b) – and how the proposals were influenced by broader strategies for welfare reform. It analyses the policy documents across changing ideological standpoints following the 2010 change of government from New Labour to a Conservative-dominated coalition with the Liberal Democrats. The intention is not to assess the implementation of all the personalisation policy reforms set out in the key government documents, but rather to examine the documents as artefacts of the broader welfare and public policy reform ideologies of the different administrations. In this way it is possible to explore how some of the wider government public sector reform strategies have shaped personalisation implementation proposals. The methodology is informed by a documentary analysis approach. This exploration of key personalisation policy documents highlights how they bear the hallmarks of wider welfare reform approaches in both administrations and draws on critical perspectives offered by selected academics. The analysis draws on research-based explorations of the ‘modernisation’ and ‘transformation’ reform agendas in adult social care (Newman et al, 2008), refers to a critique of joined-up government (Pollitt, 2003) and traces adult social care policy evolution (Means, 2012). Evidence is drawn from findings from the individual budgets (IB) pilot evaluation (Glendinning et al, 2011; Moran et al, 2011).

Means (2012) offers a helpful historical perspective for contexualising personalisation reforms in adult social care. He sees the agenda as belonging within a historical continuum of policy development, where major themes about funding, quality, provision, access and defining social care continually re-emerge as challenges.

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In order to answer the question in the title, this chapter presents a brief investigation into the origins of the concept of ‘co-production’ and an exploration of how it has functioned in UK social policy rhetoric since the mid-2000s. In doing so, it traces what could be termed its ‘ownership records’, to examine how the policy concept is being, or can be, implemented in practice. Critical questions, informed by international literature on the topic, are asked about the true potential of ‘co-production’ to facilitate radical power shifts towards disenfranchised or marginalised service users and citizens, and to fundamentally change how policy decision making and public service provision is done.

The origins and meaning of co-production as a way of facilitating power sharing and decision making with citizens and/or service users as equals in social policy and public service provision are somewhat confused or at least contested (Scourfield, 2015). It appears to be a policy idea that has gradually become ‘lost in translation’, even at early stages of conceptualisation, and as a result co-production can be as difficult to define as it is to do. Bovaird suggests that co-production comes in a variety of forms, and is often specific to particular contexts (Bovaird, 2007), while Ewert and Evers argued: ‘in a changed welfare environment, there is no dominant, coherent narrative for co-production … co-production refers to a fragmented set of activities, expectations and rationales’ (Ewert and Evers, 2014: 427).

Despite this, it is generally agreed that the first individuals to use the term were Elinor and Victor Ostrom, who developed the concept to describe relationships between citizens and public institutions, in the context of US public management research (Ostrom and Ostrom, 1977).

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When it first appeared, the adult social care personalisation policy seemed to assume that there was a universal understanding of the policy terminology, meaning and aims, which included a rhetorical commitment to ‘empowerment’, ‘co-production’ and ‘choice and control’ (HM Government, 2007). However, Beresford’s analysis provides insight into some of the confusions of meaning and contradictions inherent in this policy for adult social care. Other critics and observers also agree that as a public policy discourse, personalisation is imprecise, ambiguous and contains certain internal inconsistencies and tensions (Cutler et al, 2007; Pykett, 2009; Roulstone and Morgan, 2009; Needham, 2011a; 2011b), particularly as regards the conceptualisation, design and operation of the personal budget scheme in England (Boxall et al, 2009; Audit Commission, 2010; Carr, 2011a). This response is an attempt to deepen Beresford’s criticisms about personalisation not being ‘a user-led development’ and offers an expansion of his exploration of its origins by further critiquing the influential ideas of Charles Leadbeater.

Before it was introduced for adult social care, the personalisation agenda had already formed part of the policy for education reform and was being championed by the social policy think tank Demos (for an extensive critique, see Pykett, 2009), particularly through the work of Charles Leadbeater, a former Financial Times editor, management consultant and policy advisor to Tony Blair, with no experience in adult social care. Despite this, Leadbeater and Demos had a profound influence on the personalisation agenda for adult social care, with Demos publishing Making it personal (Leadbeater et al, 2008), a largely theoretical outline for reform, two months after the 2008 local authority circular outlining the adult social care transformation plans (Department of Health, 2008).

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An international introduction to participatory welfare

Social policy is often constructed and implemented by people who have little experience of its impact as a service user, but there has been a growing interest in greater public, patient and service user involvement in social policy as both political activity and academic discipline.

Social Policy First Hand is the first comprehensive international social policy text from a participatory perspective and presents a new service user-led social policy that addresses the current challenges in welfare provision.

A companion volume to Peter Beresford’s bestselling All our welfare, it introduces the voices of different groups of service users, starting from their lived experience. With an impressive list of contributors, this important volume fills a gap in looking at social policy using participatory and inclusive approaches and the use of experiential knowledge in its construction. It will challenge traditional state and market-led approaches to welfare.

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Editing this book has been a major project. Two things directly encouraged us to embark upon it. First, our own personal experience of the inadequacy of traditional social policies and services and second, our experience as activists that people’s participation could make possible a more hopeful alternative. We felt both that conventional social policy has lost its way and that participatory social policy had something very helpful to offer instead. The work we have done in putting the book together, the contacts we have made and the developments we have discovered mean that our own understanding has expanded, rather than remained static. We have learned so much – especially internationally – and we hope that this book also offers that opportunity to readers. Editing it has opened our eyes to just how much is going on to advance participatory social work in theory and practice globally. It has confirmed our and other people’s growing concerns that traditional social policy, whether of the political left or right, may be set on a road to nowhere, the two cancelling each other out. Proposals either continue to be prescriptive and therefore politically weak or backward looking, cutting welfare, turning to the market, deluding us that this offers a way forward. In our view, the Grenfell Tower tragedy in the UK, in which so many died unnecessarily, is likely to have reverberations for social policy much more widely and for much longer than could ever have been imagined. It has given the lie to previously unchallengeable arguments that public spending is wasteful and damaging, that spending cuts are synonymous with ‘efficiency savings’ and that only the private sector can ensure that the ‘consumer is king’, rights and social responsibility secured and the voice of the citizen heard (Walker, 2017).

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I’m grateful that, after an early life of being silenced, sometimes violently, I grew up to have a voice, circumstances that will always bind me to the rights of the voiceless. (Solnit, 2014)

For years there have been growing calls for a different approach to social policy; one that is truly participatory and democratic, rather than paternalistic and controlling. This book is a response to that demand. It is the first exploration of participatory social policy internationally, critiquing its nature, origins and possibilities, as well as the issues and problems it faces.

The promise of participatory social policy is that where people need help or support, or for their rights to be safeguarded, they have a real say in that process, instead of having someone else’s moral, ideological, economic, policy or social solutions imposed on them, as has so long been the case. Yet despite the popular support for participatory social policy, it has so far made very limited progress globally. Perhaps this is not surprising. Social policy continues to be a battleground between contending political and ideological forces; each with its policy prescriptions and agendas to pursue. Meanwhile, the subjects of social policy, especially of its more ‘heavy end’, have had little role in shaping it, often serving only as a stage army that is either patronised or stigmatised, frequently marginalised and excluded from mainstream society. In addition they have largely been excluded from debates, discussions and the formulation of social policy as both an area of policymaking and an academic discipline.

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