‘No more throw-away people – the co-production imperative’ by Ruth Dineen

Introduction by Professor Marcus Longley, Director of WIHSC and Professor of Applied Health Policy

Ever wondered what ‘co-production’ really is, but been too embarrassed to ask?  Well, save your blushes, and read on…  This week’s blog in our ’20 blogs for 20 years’ series is by Ruth Dineen, who knows more about co-production – and has done more to promote it – probably than anyone else in Wales.  Ruth is joint head of Co-production Wales

‘No more throw-away people – the co-production imperative’*

Last year, a number of those involved in developing the Social Services & Well-being Act and received a letter from Edgar Cahn – an American civil rights lawyer and founding father of the international co-production movement.

‘I just learned of your breakthrough achievement: embedding the co-production imperative into the health care system in Wales. This is an act of profound importance in an age that seems only to value budget cuts as a form of efficiency.

You did it. You worked from the inside to make this remarkable achievement possible. And I was thrilled to hear of how your efforts joined with others’ … [to culminate] in an affirmation of what we need to hold most precious: the strengths and capacities of community members to care for each other and to live vibrantly and well through mutual support, trust, and strengths.

Yours is a first.’

This was a high point.

Co-production – an asset-based approach to public services based on equal and reciprocal relationships between state and citizens – appeared to have entered the mainstream. Wales was in the vanguard of an international movement for social justice.

So what happened next? Is co-production here to stay? And if not, why not?

On the plus side are growing numbers of supporters and practitioners: professionals and citizens, researchers, government officials and politicians. There’s a compelling evidence base and a wealth of real people’s stories. Co-production inspires and engages. It transforms lives and services. In other words, it works.

But not everyone is a fan. Some assume that co-pro is just a re-branding exercise with nothing new to offer; some argue that it is a neo-liberal con-trick – an attempt to get volunteers to do what the state should be doing. And some confuse co-production with engagement, consultation and collaboration.

Such challenges are not insurmountable. Misapprehensions can be refuted and people persuaded.

A more significant barrier to progress is an apparent gap between the stated desire of government to act as an enabler of co-produced services and their subsequent willingness to invest in that change. Our shared ambitions will only be achieved if state and citizens have a sense of common purpose based on relationships of trust and reciprocity. That requires time, real commitment and explicit, funded support.

There’s a long way to go.

 Ruth Dineen, Joint Head, Co-production Wales

* Cahn, Edgar (2004) No more throw-away people. The co-production imperative, Time Banks USA, Washington.

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