Critical perspectives on ‘consumer involvement’ in health research: epistemological dissonance and the know-do gap

Researchers in the area of health and social care (both in Australia and internationally) are encouraged to involve consumers throughout the research process, often on ethical, political and methodological grounds, or simply as ‘good practice’. This paper presents findings from a qualitative study in the UK of researchers’ experiences and views of consumer involvement in health research. Two main themes are presented in the paper. Firstly, we explore the ‘know-do gap’ which relates to the tensions between researchers’ perceptions of the potential benefits of, and their actual practices in relation to, consumer involvement. Secondly, we focus on one of the reasons for this ‘know-do gap’, namely epistemological dissonance. Findings are linked to issues around consumerism in research, lay/professional knowledges, the (re)production of professional and consumer identities and the maintenance of boundaries between consumers and researchers

Clients or citizens? Some considerations for primary care organisations

Health services policy in the United Kingdom has given prominence to patient and public participation within a 'modernization' agenda. The superficial consensus in support of lay participation masks a conflicting array of ideologies and theoretical perspectives that colour how this is interpreted. Both client-oriented perspectives and citizenship-oriented approaches are limited by the dynamics of power relationships and decision-making processes within National Health Service structures. Primary care organisations offer the possibility of developing structures for providing closer collaboration between citizens and services. In order to achieve this, however, vague processes of client representation need to be replaced by robust community-based participatory action research models