A few years ago I helped with a door to door survey on a grotty council estate. I had been drafted on to some ménage à trois collaboration (academic, service, and voluntary sector), and we were heavy on hearing local voices.
I had helped design the survey and done my utmost to ensure that it was evidence based. We especially wanted to include refugees, chain smokers, single parents, people who didn't speak English, the unemployed, people who sell sex, those addicted to illegal substances, etc, so that we could design accessible and culturally congruent services at the interface between health and social care.
I parked my car two miles away and made my way across a motorway bridge, through an alley, past burnt out vans and abandoned junk, to the far corner of the estate, where my target block of most-deprived flats lay.
Times have moved on. You can now explore the perspective of society's have-nots without setting foot outside your ivory tower. Just send them the URL of the Department of Health's latest listening exercise, “Your health, your care, your say” (www.nhs.uk/yoursay/). Your sample can simply click a radio button to indicate whether they would prefer to receive “Information, support and advice on tackling drug use,” “An NHS book on taking care of your own health,” or “Routine physical examinations for anyone who wants one.”
Their responses constitute, in the government's own words, “democracy in action.” They will—presumably—be collated and used to prioritise community based service provision for the disempowered and socially excluded. Because thousands of people have clicked their way through the survey, the data generated will be robust and reliable—or so the government thinks. Because people have been asked for their views directly, rather than professionals or voluntary sector advocates speaking on their behalf, service users are expected to be more empowered.
An elderly woman has just been given a suspended prison sentence for suffocating her severely disturbed and violent 36 year old autistic son. She had been his devoted carer for 30 years, and had written repeatedly to social services pleading for help, with no meaningful response. Now there's a listening exercise that the government might like to reflect on.