MANAGING HEALTH AND SOCIAL CARE

Managing Health and Social care

Managing Health and Social care

Introduction

The concept of participation is very much an “in vogue” concept within health care circles, so much so, that new ways to move the balance of service user involvement is consistently being evolved and developed to procure a better understanding of what the service user is experiencing and also needing to improve, develop and pseudo-manage their levels of care and intervention with a firm voice. This active community participation is not a new concept; it is primarily as suggested by Rifkin (1990) that:

There is no agreement among planners and professionals about the contribution of community participation to improving the lives of people … Some completely dismiss its value altogether, while others believe that it is the 'magic bullet', that will ensure improvements”. “ With the wealth of legislative changes and subsequent regulation and directives; the service user has become a very important person in the world of health and also social care. These two sectors are often place together, but more importantly they have their own agendas and areas of specific management strategy that impact upon the needs and involvement of the service user. Therefore, we shall explore the concept of the socio-historical context of participation and collaboration; legislative mandated requirements; management measurements and involvement; service user and service collaboration and the inter-agency and partnerships that are now engaging the service user.

Even with a lack of consistent agreement the notion of community participation has been a continual development concept when planning, managing and engaging services for improving communities. Despite this lack of agreement, community participation has remained “in vogue”, and as such been a fundamental ingredient for programme planning and development. Equally, Arnstien (1969), in her analysis of participation, developed her “Participation Ladder”; this prime example of the concepts core notion, shows that participation has and is a consistent and “in vogue” concept, that has been clearly debated and conceptualized.

When the World Health Organisation (WHO) took on board the concept of participation with communities as a core concept, they were able to focus their efforts on the beneficiaries of such promotional primary health care programmes; the design and implementation of which were crucially managed from within the realm of the service user who alongside managers of programmes were able to ensure good collaboration and partnerships with key organisations. Why was this unilateral acceptance crucial to the development of community participation programmes? In retrospect, Rifkin suggests that the reasons against the core values of health, economics, promotion and social justice are as follows:“The health services argument: the services provided are under utilized and misused, because the people for whom they are designed are not involved in their development. The economic argument: there exists in all communities, financial, material and human resources that could and should be mobilized to improve local health and environmental conditions. The health promotion argument: the greatest improvement in peoples' health is a result of what they do to and for ...