Participation, Involvement and Engagement – More Than a Question of Semantics
Our focus of inquiry is on a relatively new body Healthwatch, described as a ‘consumer champion’. Healthwatch is mandated to involve volunteers in its work of amplifying the voice of local people who use statutory health and social care services. Commissioned by local authorities, Healthwatch organisations are entitled to a seat on the local Health and Wellbeing Board. They have powers to ‘enter and view’ NHS and social care establishments and report their findings to these providers and to commissioners.
Preliminary findings suggest that statutory bodies are actively engaging local public(s) as they plan for service transformation. Recognisable tensions surface around how public(s) are constituted, how deliberative or not methods of engagement are, as well as the usual problematic issue of representation. Unexpected and novel findings are emerging around legal definitions and requirements for statutory consultation in the context of major service changes. It appears that patient and public engagement is being carried out in an attempt to pre-empt objection to proposed service changes when these are formally presented for legal consultation. This raises interesting theoretical questions about governance and governmentality and empirical questions concerning agenda setting and manipulation versus empowerment and co-production.