Policies of user participation: The case of older people and social care in Norway and England
Karen Christensen | University of Bergen
User participation has become one of the most important concepts in the social care sector in both Norway and England; increasingly this is presented as a goal when designing the services. While there has been much emphasis on user participation in literature related to disabled people or those with mental health problems, this is a neglected subject in relation to older people. The objective of our study is to specifically investigate and compare the policies of user participation directed at older people in the social care sector in Norway and England. The comparison is particularly relevant because these two northern European countries represent two different welfare regimes: one ‘social democratic’ in the case of Norway, and in the case of England increasingly a ‘liberal’ type from the time of the Conservative government at the end of the 1970s.
Although the formal basis for change in social care policies are government policy documents, setting out proposals for future legislation, they are rarely analysed per se. We will analyse such national policy documents, primarily a selection of White Papers from the 1960s until today, using a discourse analytical approach inspired by Bacchi (1999). Our historical comparison of Norwegian and English discourses about user participation will be related to the different discourses discussed in the research literature; particularly the distinction between a ‘democratic/rights based’ one and a ‘consumer-oriented one’. The democracy rationale comes from the right of individuals to control their own lives, as full citizens in society. It is about influence on policy development, resource allocation and governance. The consumer rationale views the individual user as a consumer of services, who should have the right to choose for example from a market of service providers. Additionally, also a discourse about co-production, underlining partnership between the user and state/local authority is currently discussed.
Our analysis will show how these different discourses appear in our selection of national policy documents over time, but with a time difference as well as a difference in strength and type of presentation in the two countries. In both countries, however, there is a change towards a stronger emphasis in expecting people to remain active, independent and connected to their communities to delay or prevent the need for social care.