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The productive techniques and constitutive effects of ‘evidence-based policy’ and ‘consumer participation’ discourses in health policy processes

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  • Lancaster, K.
  • Seear, K.
  • Treloar, C.
  • Ritter, A.

Abstract

For over twenty years there have been calls for greater ‘consumer’ participation in health decision-making. While it is recognised by governments and other stakeholders that ‘consumer’ participation is desirable, barriers to meaningful involvement nonetheless remain. It has been suggested that the reifying of ‘evidence-based policy’ may be limiting opportunities for participation, through the way this discourse legitimates particular voices to the exclusion of others. Others have suggested that assumptions underpinning the very notion of the ‘affected community’ or ‘consumers’ as fixed and bounded ‘policy publics’ need to be problematised. In this paper, drawing on interviews (n = 41) with individuals closely involved in Australian drug policy discussions, we critically interrogate the productive techniques and constitutive effects of ‘evidence-based policy’ and ‘consumer participation’ discourses in the context of drug policy processes. To inform our analysis, we draw on and combine a number of critical perspectives including Foucault's concept of subjugated knowledges, the work of feminist theorists, as well as recent work regarding conceptualisations of emergent policy publics. First, we explore how the subject position of ‘consumer’ might be seen as enacted in the material-discursive practices of ‘evidence-based policy’ and ‘consumer participation’ in drug policy processes. Secondly, we consider the centralising power-effects of the dominant ‘evidence-based policy’ paradigm, and how resistance may be thought about in this context. We suggest that such interrogation has potential to recast the call for ‘consumer’ participation in health policy decision-making and drug policy processes.

Suggested Citation

  • Lancaster, K. & Seear, K. & Treloar, C. & Ritter, A., 2017. "The productive techniques and constitutive effects of ‘evidence-based policy’ and ‘consumer participation’ discourses in health policy processes," Social Science & Medicine, Elsevier, vol. 176(C), pages 60-68.
  • Handle: RePEc:eee:socmed:v:176:y:2017:i:c:p:60-68
    DOI: 10.1016/j.socscimed.2017.01.031
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    References listed on IDEAS

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    1. Wait, Suzanne & Nolte, Ellen, 2006. "Public involvement policies in health: exploring their conceptual basis," Health Economics, Policy and Law, Cambridge University Press, vol. 1(2), pages 149-162, April.
    2. Radcliffe, Polly & Stevens, Alex, 2008. "Are drug treatment services only for 'thieving junkie scumbags'? Drug users and the management of stigmatised identities," Social Science & Medicine, Elsevier, vol. 67(7), pages 1065-1073, October.
    3. Tritter, Jonathan Quetzal & McCallum, Alison, 2006. "The snakes and ladders of user involvement: Moving beyond Arnstein," Health Policy, Elsevier, vol. 76(2), pages 156-168, April.
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    2. Rhodes, Tim, 2018. "The becoming of methadone in Kenya: How an intervention's implementation constitutes recovery potential," Social Science & Medicine, Elsevier, vol. 201(C), pages 71-79.

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