Co-production and person-centred care in neoliberal conditions

Blunden, Nicola; Calder, Gideon

Abstract

The personalization of care holds an ideological ambivalence that allows for diverse and sometimes contradictory appropriations. To be person-centred may seem to be definitively unobjectionable: what is not to like about an approach that puts the user of a service at the centre of service provision? But this assumption should itself sound alarm bells. One way of characterizing this is a concern about false neutrality. Some may endorse person- centred care thinking as something that is somehow normatively or politically neutral, when in fact it involves certain contentious value commitments. Those commitments themselves must be defended in critical relation to other candidates, rather than simply asserted. Another way of thinking about the problem is in terms of false abstraction. It is one thing to ‘read the manual’ on person-centred care, and appreciate in the abstract its elegance, coherence and moral force. But it is quite another thing to try to enact it in practice and another again to consider it ‘achieved’ in a substantial way. In this chapter, we explore this ideological ambivalence by setting person- centred care alongside two other themes. The first is co- production, a distinct approach to service provision which overlaps in many ways with person-centred care, but might be seen as contending with a wider set of social and political factors in order to be realized. This is significant in terms of the false neutrality concern: we wonder whether co-production helps draw out and make good on the promise of the value-commitments of person-centred care. The second theme is the socio-economic conditions under which practice takes place - which, for the purposes of this discussion, we address under the heading of neoliberalism. These conditions matter because of the false abstraction concern. If an approach is compelling in practice, but muted, inhibited or rendered counter-productive by the structural conditions in which it is applied, then the degree to which it is a ‘good thing’ is duly in question.

• Journal Article Type: Article
• Publication Date: 2020
• Deposit Date: Nov 13, 2023
• Journal: European Journal for Person Centered Healthcare
• Print ISSN: 0890-2070
• Electronic ISSN: 1099-0984
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 1
• Pages: 75-85
• Public URL: https://uwe-repository.worktribe.com/output/11444212
• Publisher URL: http://www.ejpch.org/ejpch/article/view/1822