It’s no big news to point to the increased emphasis on ‘co-production’ in public policy. For professional services and products, this implies that clients or service users – the community in other words – will be active involved as co-developers in designing and delivering public services. The general rationale is that ‘service user’ voice and choice needs to be taken more seriously by professionals. The other driver, of course, is funding cuts to public services which means finding more creative ways to deliver them. In the UK, a report released by the New Economics Foundation called for co-production in all public services to foster the principle of ‘equal partnership’. The tone of some of this material is almost utopian. In fact, writers like Tony Bovaird have argued that a shift to public service co-production with its promises of greater democracy and active citizenship would be ‘transformative’. All of these discussions pose important questions about the changing nature and value of professional work, expertise and knowledge. And these questions have implications for professional continuing education and learning.
The problem with much of the existing debate on co-production is that it has tended to be concentrated at the level of policy and prescription. Here visions of reform flourish in aspirational documents lauding the ‘revolutionary’ potential of co-productive arrangements to build social cohesion, citizen empowerment, improved services, and of course, economic efficiency. What actually happens at the chalkface of practice in such arrangements is less well known. Indeed, there is little research yet establishing that this co-production ideal is even possible. This points to a first major problem, not unfamiliar in policy for public service, where a particular prescription for reform precedes evidence demonstrating its effectiveness, feasibility, and unanticipated consequences.
A second problem is that, at least in UK discussions, the co-production discourse still tends to promote universal ideals for all aspects of public service. While public policy to a certain extent must remain at the level of general guidance to allow diverse implementations at local sites, the spirit of the policy can be quickly eroded when it fails to acknowledge even the most basic distinctions and issues. For example, why should ‘authentic’ co-production always involve service users in the planning as well as the delivery of services? Is this appropriate in services requiring specialist expertise and equipment such as medical surgery or emergency medical response? Is full involvement of service users appropriate in disciplinary services such as security and crime management?
Indeed, do service users even desire to be fully involved in designing and delivering all of the public services that they access? What happens with user involvement in services such as psychiatric and dementia care where issues of user capacity and family may be central? And what happens with accountability for professional service, and costs? Are users supposed to share these as well? The co-production discourse often does not engage these issues.
However there are writers out there who have probed co-production critically, while also pointing to its possibilities. Catherine Needham (2007) for instance argues that co-production arrangements create tensions for professionals between demands to care and demands to contain or control. She also shows how co-production blurs the boundaries of authority and responsibility in situations of health and social care, and raises questions about who has power to make decisions in public service delivery (Needham 2006). More recently she has collaborated with Catherine Durose and other colleagues at the University of Birmingham to produce a useful and reasonably critical overview of co-production Transforming local public services through co-production (2013).
In the Australian context, two writers on co-production in health care who have particularly provoked my thinking are Alison Lee and Roger Dunston. Tragically, Alison died in 2012 but their work is available in various sources, including a chapter in a book that I recently edited with Monika Nerland called Reconceptualising Professional Learning (Routledge 2014). Roger and Alison have drawn attention in particular to the ways that the co-production discourse perpetuates the hierarchical separation of ‘users’ from ‘professionals, and they suggest new conceptions to reconfigure this binary.
In my own work I examined co-production in policing practices where, inspired by Alison and Roger, I was trying to develop more multi-layered models. I was interested in empirical questions such as, How do participants in a co-produced form of professional service – both practitioners and members of the community – negotiate decision making and authority, mutual expectations, client relations and standards of practice? What sorts of conflicts, uncertainties and compromises are generated through co-production? I have published this work here, in an open source journal that is a great resource for researchers in professional work called Professions and Professionalism.
Bovaird, T. (2007). Beyond engagement and participation: user and community coproduction of public services. Public Administration Review, 67, 846-860.
Boyle, D. & Harris, M. (2009). The challenge of co-production. London, UK: New Economics Foundation. Retrieved on 13 July 2012 from http://www.nesta.org.uk/library/documents/Co-production-report.pdf
Needham, C. (2006). Coproduction in public services: opportunity or threat? Renewal, 14 (2), 55–60.
Needham, C. (2007). Realising the potential of co-production: Negotiating improvements in public services. Social Policy and Society 7, 221-231