This chapter seeks to offer a critical analysis of issues of power and oppression in relation to what in the UK has become known as ‘service user involvement’. Over the past 25 years, a series of major policy changes has significantly raised the profile of service user involvement in the delivery of public services. Beginning with the National Health Service and Community Care Act (1990), which placed statutory duties to consult service users, to more recent developments such as Putting People First (Department of Health, 2007), service providers have been mandated to ensure full user involvement in the planning, commissioning and delivery of services. However, if institutional responses are relatively recent, the struggles of service users and citizens over health and welfare provision are not. Therefore, in this regard, any discussion that seeks to uncover the challenges and possibilities in ensuring effective participation of service users needs to be situated in a broader examination of the history of service user movements.
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