Kelly, J. (2008), "Creating Citizen‐Consumers: Changing Publics and Changing Public Services", International Journal of Public Sector Management, Vol. 21 No. 1, pp. 93-94. https://doi.org/10.1108/09513550810846131
Emerald Group Publishing Limited
Copyright © 2008, Emerald Group Publishing Limited
The spread of consumerism and its manifestation in widening users' choice when they access public services may be perceived as the latest fad by the neo‐modernisers associated closely with Tony Blair. In this book, the authors look beyond the influence of Blair and the specificity of New Labour, to offer a substantial analysis of the theoretical political, policy and practice issues in the shift towards consumerism in public services.
Firmly grounded on empirical evidence, the authors explore on‐going controversies about the citizen‐consumer as a driver to reform public services to bring them in line with the experiences and expectations of a consumer society. In a well‐written and cogent piece of work, the authors explore how the “discourses of consumerism” has affected the nature of UK public service organizations, how public sector professionals responded to the new policy discourse and the impact on public services and their users. Hence, the book not only considers the antecedents of the rise of the citizen‐consumer but also includes insights into how practitioners responded in turn to the choice agenda and the implications of these developments to the changing expectations of the users.
To explore the notion of citizen‐consumer, the authors adopted a multi‐theoretical approach comprising of the sociology of modernity, political economy and neo‐liberalism and governmentality. By doing so, the authors offer an analysis which captures the complexity and diversity of different perspectives and different visibilities, without privileging one perspective over another. What this means in practice, is that narrative is vastly more sophisticated than by those who prefer conventional approaches to policy analyses. In other words, the narrative captures the contradictory and often messiness that occurs in the space between the making and the implementation of specific policies.
Turning to the substance of the book, the first chapter outlines the theoretical perspectives employed by the authors, to argue how the notion of citizen‐consumer is more than a rhetorical devise used by New Labour (p28). The second chapter focuses attention on how the notion of citizen‐consumer has displaced other terms in discussions and debates about public sector reform. Chapters 3 to 6 introduce the case studies, first by asking how the notion of citizen‐consumer has affected service delivery, with perspectives from the users, the providers and the service in more general terms. Included in these chapters are specific discussions on institutional variations, the encounters between users, staff and services and the implications of consumerism on the configuration of public services. From different perspectives the authors return to the implications of choice and the tensions creation with other values, such as equality, responsibilities and rights. In support of their argument, the authors have included material from their respondents. The voices of those who provide and use these very different services accordingly emphasises the challenges and dilemmas within contemporary public services.
The three case study services, health care, police and social care have adopted and responded in quite different ways to the citizen‐consumer agenda. Each of these services experienced considerable upheaval from earlier waves of public sector reform, which affected the operation of these services quite differently. All, however, faced similar challenges, which were intended to reduce authority‐power of providers. The narratives from earlier reforms persist in the latest round of reform, of being “more business‐like” and similar mantras. Such narratives, along with the notion of citizen‐consumer, fit at least superficially to health care and social care. In the case of the Police Service, however, the contradictions in the linked concepts of citizen‐consumer are most exposed. In the case of health care and social care, expanded user choice has presented other challenges; of increased expectations and the pressures to manage demand.
Undoubtedly, as the authors acknowledge, public sector reform has brought beneficial changes; better appointment systems at outpatient clinics, the empowerment of expert‐patients, and more independence for users of social care to name a few examples. However, as the authors argue, the consumerist agenda in public services challenges the core assumption of the relationship between the state and the citizen, which are yet to be resolved. Moreover, the expert‐patient has expertise in their medical condition, yet they do not have professional knowledge of the highly skilled practitioner. In the case of the elderly, vulnerable and those at risk, it remains the case that the role of government is to protect and safeguard by providing advice and guidance, which appears at odds with the notions of fully informed rational consumers exercising choice.
Inevitably, with such a book, there are gaps and omissions. Why the particular case studies were chosen was not explained. In the example of healthcare, there is such diversity between locality, specialisms and primary and acute care, which would suggest that the consumerist agenda would play out differently because of these variables. Lastly, the most notable flaw is that the authors declined to place consumerism and the notion of citizen‐consumer in the context of the on‐going debates on New Public Management.
Nevertheless, this is an excellent volume; well‐written, grounded on research and will be of interest to students and practitioners interested in current debates in public and social policy. Some readers may find that the multi‐theoretical approach and textual analysis rather daunting, as some prior knowledge and scholarship is necessary to follow the core themes. Nevertheless, the challenge is worth it.