Introduction

Increasingly, professionals find themselves operating in a policy context where governments seek greater levels of community involvement and participation. For example, a Scottish Government consultation on a proposed Empowerment and Community Renewal Bill (Scottish Government, 2012) aims to ‘ensure communities are able to have a greater role in determining how their local public services are delivered’ (p 5). In Australia, partnership with health service users in planning, designing and evaluating healthcare is one of ten National Safety and Quality Health Service Standards (Australian Commission on Safety and Quality in Health Care, 2011).

The authors welcome this focus, but it does cause them to think about what they understand community involvement to mean, and to consider whether this matches the government view. And, for that matter, do the authors, with different professional cultures, share common understandings and beliefs? This is especially relevant where the values and ethics of involvement are a benchmark for professional practice. The Community Learning and Development (CLD) Standards Council in Scotland (2011), for example, describes a commitment to education as a prerequisite for democracy and citizenship, characterised by ‘actively engaging those who are excluded from participation in key social processes that shape their lives’ (p 18). In Australia, guidelines for the ethical conduct of evaluations (Australasian Evaluation Society, 2006) emphasise the involvement of all stakeholders and the need to take account of social differences and inequalities. Research and evaluation in health is guided by a national statement on participation (National Health and Medical Research Council and Consumers’ Health Forum of Australia, 2004), which advocates a range of strategies to ensure that participation is embedded in policies and procedures and is adequately funded. This means that the long process of changing structures and attitudes is given enough time and commitment, and the crucial support from senior leadership.

Different types and levels of involvement exist, ranging from information sharing and consultation through collaboration to consumer control, in a ‘ladder of participation’ that implies increasing consumer empowerment (Boote et al, 2002). Arnstein's (1969) model of participation, still influential with practitioners and policy makers, emphasises that empowerment, and hence true participation, is achieved only through partnership and delegation. Strategies on the lower rungs of the ladder are described as passive involvement.