Co-production, empowerment and a space to think

[David Boyle]

I’ve been thinking about co-production, spurred on as always by the brilliant Co-production Network.  And I’ve been wondering why I feel so uncomfortable about the language of ‘empowerment’.

I have come to two conclusions.  The first is philosophical.  The ‘empowerment’ language began to seep into public discourse during the Blair years, where the government of the day had a very hazy idea of the philosophy of power.

The truth is that it is not in our gift to give people power.  The constitution doesn’t allow it.  The mechanisms don’t exist.  They either have power or they don’t.

What we can do is encourage people, and provide them with the institutions they need, so that they can exercise that power.

It misunderstands and misleads when we talk about ‘empowerment’.  That is not the issue: the point is how we can provide a means for people to exercise the power they already have.

Perhaps I am splitting hairs, but there is a serious point behind this when it comes to co-production. 

It seems to me that we risk watering down the core of co-production when we describe any of the various ‘empowerment’ agendas as ‘co-production’.

Because, despite all the talk of empowerment from the very top of government over the past 15 years, people’s lives are not that different.  The power has failed to transfer.  Apart from some notable exceptions, the empowerment agenda has not succeeded.

Far from being another form of empowerment, co-production is a critique of it – it is a potential explanation of why conventional empowerment has failed.  The co-production agenda suggests that the power imbalance has remained because people have stayed passive – they have not been encouraged to help deliver services alongside professionals.

The co-production critique claims that, only then, does the power shift, and it isn’t general activity nor representation, nor user voice, nor users on the board which does it – important as those reforms are for other reasons. 

Co-production suggests that the power shifts only indirectly, when people deliver services themselves – partly because the professionals come to rely on them, partly because they see themselves differently, partly because something alchemical happens when they do.

That is a big difference, and not everyone will agree with me.  But it emphasises to me how much we need thinking space about these ideas – not thinking divorced from practice, but absolutely linked together.

Which is why I’m excited about the new postgraduate certificate in co-production in health, which is due to start next year at Leeds Business School via the Centre for Innovation in Health Management, which plays such a pivotal role at spreading these ideas in the NHS. 

The existence of a new qualification is a sign that co-production has come of age in the UK, certainly in health.  But it is also the way we will build a new cadre of co-production professionals who will fan out and put these powerful ideas into practice.