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Article
Publication date: 19 June 2009

Anna Leppo and Riikka Perälä

The new “agenda of choice” in public services emphasises service users' needs and agency. The ideals of consumerism and user involvement have set new challenges for professionals…

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Abstract

Purpose

The new “agenda of choice” in public services emphasises service users' needs and agency. The ideals of consumerism and user involvement have set new challenges for professionals. This paper aims to explore the effects of consumerism and user involvement at the level of day‐to‐day service delivery, looking at the encounters between professionals and service users.

Design/methodology/approach

The paper applies an ethnographic approach. Observation data were collected at two Finnish drug treatment institutions: a needle exchange and health counselling service, and a specialised maternity clinic for pregnant women. Data from each institution consist of seven to 12 months of participant observation notes, which were subsequently systematically coded and analysed comparing the two institutions.

Findings

The promotion of new ideals does not automatically result in the empowerment of service users or the erosion of professional power. The two institutions differ greatly: institutional context and gender shape the everyday realisation of the new ideals. In both institutions, however, professionals have adopted new practices and rethought their role. The cultivation of service users' choice and agency can become valuable professional capital, a new kind of “know how” that can also be used by the professionals to justify the importance of their work.

Originality/value

The paper provides a nuanced and contextualised insight into “how” the ideals of consumerism and user involvement are translated into everyday encounters between service providers and users.

Details

Journal of Health Organization and Management, vol. 23 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

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902

Abstract

Details

Journal of Health Organization and Management, vol. 23 no. 3
Type: Research Article
ISSN: 1477-7266

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