Victorian Consumers Participate in Health

Introduction to Consumer Participation

Health issues affect us all. People who need or receive health care, or who are largely unpaid carers for people who do, are health consumers. Often they want to have some say over how health care happens and what it involves.

Consumers may decide to 'get active' in health in response to a single local issue or common experience. Or people might decide they need to form a group to represent interests that come from their shared identity as a community

This is part of a worldwide consumer movement that has begun to change the way that governments and private providers think and act. Governments and funding bodies often expect to hear from consumers now, and have begun to realise that consumers have a lot of valuable knowledge to offer. This in turn is likely to lead to better health.

What Is Consumer Participation?
Definitions vary due to different philosophies and politics of consumer participation.

What is a Consumer?

"…people who are current or potential users of health services"
(Victorian Department of Human Services, 2005, Participation in your Health Service System: Victorian Consumers, Carers, and the Community Working Together with their Health Service and the Department of Human Services)

"…people who either directly or indirectly make use of health services. Consumers are as diverse as the full range of people living in contemporary Australian society. Any definition of "consumer" must incorporate women and men, people from diverse cultural experiences, class positions and social circumstances, sexual orientations, health and illness conditions."
(Consumer Focus Collaboration, 2000, Improving Health Services Through Consumer Participation: A Resource Guide for Organisations, p. 4)

What is Consumer Participation?

" that which encourages consideration and debate through processes that allow people to be involved in decision-making about their health care and that of the community. It necessitates the communication of your views, scrutiny of motive and an ability to listen and appreciate others' views and ideas. Through involvement decisions are made that may accommodate a range of perspectives."
(Victorian Department of Human Services, 2005, Participation in your Health Service System: Victorian Consumers, Carers, and the Community Working Together with their Health Service and the Department of Human Services)

"…the involvement of people in decisions that affect their lives. It acknowledges the importance of consulting with communities about their needs, and satisfaction with services, policies, structures and programmes. Community participation is about change."
(Not Just A Token Rep Project, 2003 (3rd ed), The Little Purple Book of Community Rep-ing, p.1).

"…the community is involved in governance activities of local councils, so they can deliver better services to the community. The community must feel engaged - informed and connected, like it has a role to play. It must also be consulted - have input into decision-making."
(Victorian Local Government Association, 2002?, Community Consultation Resource Guide)

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What are the Important Principles in Consumer Participation?

"…trust, openness, equal opportunity, advocacy and support, responsiveness, shared ownership, dissemination and evaluation"
(Victorian Department of Human Services 2005 Participation in your Health Service System: Victorian Consumers, Carers, and the Community Working Together with their Health Service and the Department of Human Services)

Lapis and Verity in Community Participation: Power, Organisation and Change listed the following principles.

Principle 1. Participation means partnership, means accepting uncertainty.
Principle 2. Deciding for effective consumer participation means deciding for organisational change.
Principle 3. Align your consumer involvement plans with organisational capacity. Involve staff in building that capacity.
Principle 4. Consumer participation must be supported from the top.
Principle 5. Consumer participation must be supported from the top down, but it is built from the bottom up.
Principle 6. It's all about relationships, so use and build people skills.
Principle 7. Consumer participation needs partnerships, partnerships need dialogue, dialogue needs trust. So build trust.
Principle 8. Multiple strategies work better.
(Lapis & Verity, 2000, Community Participation: Power, Organisation and Change cited in Consumer Focus Collaboration, 2000, Improving Health Services Through Consumer Participation: A Resource Guide for Organisations, p. 6)

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What are the Different Ways Consumers Can Participate in Health?

1. Participation in treatment and care - 'on the ground' health
2. Consultants and advocates - using their experience and knowledge to suggest how to improve services
3. Participation in service delivery and evaluation - helping to work out how to get the best and most appropriate health service to consumers
4. Participation in policy and planning
5. Participation in education and training
6. Participation in staff recruitment.
7. Participation in health research - as consultants, active subjects, researchers.

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What are the Different Levels of Consumer Participation?

Different modes of participation are sometimes represented as a continuum. Brager and Specht (1973) have developed a continuum that ranges from no participation through minimal levels where consumers receive information, but little say, through to joint planning and ultimately to consumer or community control (Consumer Focus Collaboration, 2000, Improving Health Services Through Consumer Participation: A Resource Guide for Organisations, p. 3).

The Ladder of Participation (Brager & Sprecht, 1973)

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