The origins and design of the project

Public services in the UK have been under pressure to develop a more consumerist orientation. For some, this marks a change in models of citizenship that have linked the public and public services. This project was set up to examine how three services - health care, policing and social care - have adapted to these pressures. These services have different types of user and have developed different sorts of relationship with them - so how have they responded to the consumerist imperative? Do sectoral differences affect how a consumerist orientation is developed? The project has looked at service providers based in public, private and voluntary sector based organizations. It has also contrasted different localities - to see whether local political and cultural histories affect approaches to service users.

The second strand of this project was intended to explore whether users of services see themselves as consumers, or as citizens, patients, members of the public. We ask how they experience the consumerist adaptations that service organizations have developed. Who do users think they are when they approach - or are approached by - service providers? What sorts of identities govern their interactions with public services?

The reform, improvement and modernization of public services have been a continuing preoccupation of UK governments. Funding regimes have changed, new forms of public-private mix have emerged, new systems of scrutiny and evaluation have been created. Many of these changes have been directed at satisfying the 'demanding, sceptical citizen-consumer' who uses public services. In this view, a modern society is a consumer society - and public services need to keep up with the consumer relationships that we experience in the rest of our lives. In particular, public services should offer both 'choice' (the basic element of the consumerist orientation) and high standards of service.

The result is that service providers have faced pressure to develop a more consumerist approach to their relationships with the users of their services. Our project has explored the consequences of these pressures for change. The relationships with service users and the types of encounter with users vary between services. Visiting a public library is different from attending an Accident and Emergency department. So we set out to discover how different services - health care, policing, and social care - have responded to the consumerist imperative. In part, this may reflect the different conditions in which people encounter the services - encounters which may, for example, be freely chosen, involuntary or coerced. We do not think there is one 'consumer' model - but differing interpretations and adaptations across the services.

Finally, we have been looking at how service users see themselves. Do they recognise themselves as consumers - and if so, what does this mean for them? How does the shift towards consumerism intersect with, or affect, other identities? Do they think of themselves as citizens, members of the public, or other more service specific identities? Individuals and groups may experience services in different ways, and will have both expectations and experiences of the services they encounter. The project has been exploring 'who they think they are' when they enter into relationships with service providers.

The project aimed to take stock of one of the central dynamics of change in public services in the UK. It aimed to tell policy-makers, service organizations and service users what the 'consumer revolution' has delivered - and how it has been experienced by the 'consumers'.

Methods

The project examined three public services - health care, policing and social care - in two different urban settings in England (anonymised as Old Town and New Town). It combined different methods:

1. textual analysis of government statements, national and local policy documents;
2. interviews with senior managers in the three services;
3. questionnaires distributed to front line staff and people using services;
4. follow-up interviews and focus groups with service users and staff. 

Key Questions

• How have public service organizations adapted to the consumerist imperative?
• What effects do differences between services have on the movement to a more consumerist orientation?
• Do sectoral differences (between public, private and voluntary organizations) affect what consumerism means for relations with service users?
• Does geography matter? Do places with different histories and cultures of public services respond to the consumer imperative differently?
• How do users experience the moves towards consumerist relationships?
• Who do service users think they are?