Remembering My Hat

3rd November 2009

When people are using care services

Filed under: Uncategorized — rememberingmyhat @ 12:18
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The other day in the K319 course team meeting we were talking again about the vexed question of involving service users in course production.

This is an old chestnut, which I won’t go into here (headlines – we want to do it, but how do you do it in a way which is not tokenistic yet is compatible with OU timeframes and budgets, and more fundamentallly, what do we mean by ‘service user’? Who counts as a service user? Are ‘expert’ or politicised service users the same as ‘ordinary’ service users? (No) What difference does that difference make? etc.). We didn’t resolve the issue, of course, but we had an interesting conversation about terminology.

We talked about the pitfalls of the very phrase ‘service user’. It’s a key concept in health and social care circles, especially now there’ s so much (at least lip service) effort to make care more driven by service users’ priorities and needs. We all talk about service users the whole time.

Nearly everyone is a service user to some extent – most of us go to the doctors occasionally, for example. But the phrase ‘service user’ tends to make you think of ‘an older person’, a wheelchair user, a person with learning difficulties, or whatever. It makes services users someone different from ‘us’ – it Otherises them.  ‘We’ are the professionals, the ‘normal’ people, the mainstream – ‘service users’ are the object (or subject) of our studies/policies/services.

People who use care services a lot, and whose quality of life, or even life itself, crucially depends on those services may have very different experiences of care from people who use services only more casually. And that greater knowledge and experience of being on the receiving end of care needs to be heard and acted on.

But the handy shorthand phrase ‘service user’ is quite problematic in tending to create a false ‘us’ and ‘them’ dichotomy, even if you are aware of these issues as you use it. I’m not suggesting we can abandon it altogether (I see ‘service users’ is one of my tags, which I am cheerfully going to attatch to this post) but I’m going to have a go at avoiding using it when I can. In the K319 course team we came up with the formulation  ‘when people are using care services’, which won’t cover all grammatical situations, but does a nice job of emphasising the fact that we are fundamentally talking about people and that service use is a temporal state, not an essential identity[1]

[1] Although, some people who have been involved in the politicised service user movement do identify as ‘service users’. While recognising the political utility, and sometimes necessity, of essentialised identity labels, I’d want to challenge the essentialism of that sort of ‘us’ and ‘them’ too. It’s a continuum, like most things.


  1. Hmmm very interesting!

    But I must say it doesn’t make me think of ‘an older person’, a wheelchair user, [or] a person with learning difficulties. Those mental images only popped up when you said them, and even now they’re not really sticking. Perhaps that’s something to do with where I first heard the term – although I can’t remember where that actually was.

    I think the mental image I had first was more like a sort of fried-egg shape Venn diagram, the middle bit being “activists” (the self-identified ones you allude to) and the outer bit being “people who just want to turn up and get what they need and go away again, and will never take an active part in shaping the provision of it, however much you might want them to”. (albeit with a fuzzy edge between the groups which an actual fried egg would not have 🙂 )

    But I completely agree about the “othering” potential. I think it goes with a kind of implication that someone with the label “service user” is only a user of the service, and a service designer would be in another group entirely. (and a service provider in yet a third.)

    Comment by Jennifer — 3rd November 2009 @ 21:53 | Reply

    • Fantastic image! I will forever more think of fried eggs when I think about this issue. Thank you!

      Comment by rememberingmyhat — 3rd November 2009 @ 22:34 | Reply

  2. […] Not failing already, deliberately using this term here, since the policy generally still does. Leave a […]

    Pingback by To see ourselves as others see us « Remembering My Hat — 7th January 2010 @ 14:15 | Reply

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