The Rise of the Consucrat

Document Type : Perspective

Author

Centre for Health Equity, Training and Evaluation CHETRE, University of New South Wales, South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia

Abstract

Some agents representing the ‘receiving end’ of the medical-industrial complex could be called ‘career consumers.’ We identify these consucrats as a new class of intersectional representation of ‘those affected’ in healthcare delivery systems. We describe them in the context of (similar) abocrats and femocrats but show that consucrats face more complex and different level intersectional challenges. The designation, professionalization, and representation of consucrats are problematic, in particular for public policy change. We argue for an enhanced strategic and cautious role for the consumer health movement to support consucrats.

Highlights

Commentaries Published on this Paper

  • The Pandemic, Patient Advocacy, and the Importance of Thinking; Comment on “The Rise of the Consucrat”

          Abstract | PDF

 

  • Patient, Public, Consumer, and Community Engagement: From Consucrat to Representative; Comment on “The Rise of the Consucrat”

         Abstract | PDF

 

  • Consucrats Have Agency: What Next for the Profecrat? Comment on “The Rise of the Consucrat”

         Abstract | PDF

 

Author's Response to the Commentaries

  • Consucrats and Pathocrats: The Prequel, Quel, and Sequel; A Response to the Recent Commentaries

        Abstract | PDF

Keywords

References

  1. Allsop J, Jones K, Baggott R. Health consumer groups in the UK: a new social movement? Sociol Health Illn. 2004;26(6):737-756. doi:10.1111/j.0141-9889.2004.00416.x
  2. Löfgren H, Leahy M, de Leeuw E. Democratizing Health: Consumer Groups in the Policy Process. Cheltenham: Edward Elgar Publishing Limited; 2011.
  3. Cresswell M. Psychiatric "survivors" and testimonies of self-harm. Soc Sci Med. 2005;61(8):1668-1677. doi:10.1016/j.socscimed.2005.03.033
  4. McGrath M, Reynolds J, Smolar M, et al. Identifying opportunities for engaging the 'community' in local alcohol decision-making: a literature review and synthesis. Int J Drug Policy. 2019;74:193-204. doi:10.1016/j.drugpo.2019.09.020
  5. Batt S. Health Advocacy, Inc.: How Pharmaceutical Funding Changed the Breast Cancer Movement. Vancouver: UBC Press; 2017.
  6. Rissel C. Empowerment: the holy grail of health promotion? Health Promot Int. 1994;9(1):39-47. doi:10.1093/heapro/9.1.39
  7. de Leeuw E, Wise M. Population Health Development in the Latrobe Valley: A Literature Review of World Best Practice in Building Healthy Communities and Health Systems. Melbourne: Hazelwood Mine Fire Inquiry II; 2015. http://hazelwoodinquiry.vic.gov.au/wp-content/uploads/2015/09/TOR-7-Health-Improvment-Report-of-E-de-Leeuw-M-Wise.pdf.  Accessed October 23, 2019.
  8. Dukhanin V, Topazian R, DeCamp M. Metrics and evaluation tools for patient engagement in healthcare organization-and system-level decision-making: a systematic review. Int J Health Policy Manag. 2018;7(10):889-903. doi:10.15171/ijhpm.2018.43
  9. Berger Z. Metrics of patient, public, consumer, and community engagement in healthcare systems: how should we define engagement, what are we measuring, and does it matter for patient care? comment on "metrics and evaluation tools for patient engagement in healthcare organization- and system-level decision-making: a systematic review." Int J Health Policy Manag. 2019;8(1):49-50. doi:10.15171/ijhpm.2018.94
  10. Clavier C, de Leeuw E, eds. Health Promotion and the Policy Process. Oxford: Oxford University Press; 2013.
  11. Lloyd C, King R, Bassett H, Sandland S, Savige G. Patient, client or consumer? A survey of preferred terms. Australas Psychiatry. 2001;9(4):321-324. doi:10.1046/j.1440-1665.2001.00358.x
  12. National Health and Medical Research Council (NHMRC) and Consumers Health Forum of Australia (CHF). Statement on Consumer and Community Involvement in Health and Medical Research. Canberra: NHMRC & CHF; 2016.
  13. Stewart E. Publics and Their Health Systems: Rethinking Participation. Houndmills Basingstoke: Springer/Palgrave MacMillan; 2016.
  14. Sawer M. Femocrats and Ecorats: Women's Policy Machinery in Australia, Canada and New Zealand. Geneva: United Nations Research Institute for Social Development; 1996.
  15. Eisenstein H. Inside Agitators: Australian Femocrats and the State. Sydney: Allen & Unwin; 1996.
  16. Alston M. Gender mainstreaming in practice: a view from rural Australia. NWSA J. 2006;18(2):123-147.
  17. Eisenstein H. Speaking for women? voices from the Australian femocrat experiment. Aust Fem Stud. 1991;6(14):29-42.
  18. Huggins J. The great deception: working inside the bureaucracy. Labour Hist. 1995(69):210-212. doi:10.2307/27516400
  19. Naples NA, Dobson M. Feminists and the welfare state: aboriginal health care workers and U.S. community workers of color. NWSA J. 2001;13(3):116-137.
  20. de Leeuw E, Keizer M, Hoeijmakers M. Health policy networks: connecting the disconnected. In: Clavier C, de Leeuw E, eds. Health Promotion and the Policy Process. Oxford: Oxford University Press; 2013:154-173.
  21. Mohammed K, Nolan MB, Rajjo T, et al. Creating a patient-centered health care delivery system: a systematic review of health care quality from the patient perspective. Am J Med Qual. 2016;31(1):12-21. doi:10.1177/1062860614545124
  22. Fredericks B, Adams K, Edwards R. Aboriginal community control and decolonizing health policy: a yarn from Australia. In: Löfgren H, Leahy M, de Leeuw E, eds. Democratizing Health: Consumer Groups in the Policy Process. Cheltenham: Edward Elgar Publishing Limited; 2011:81-96.
  23. Conrad P. Medicalization and social control. Annu Rev Sociol. 1992;18(1):209-232. doi:10.1146/annurev.so.18.080192.001233
  24. de Swaan A. The reluctant imperialism of the medical profession. Soc Sci Med. 1989;28(11):1165-1170. doi:10.1016/0277-9536(89)90009-9
  25. Hupe P, Hill M. Street‐level bureaucracy and public accountability. Public Adm. 2007;85(2):279-299. doi:10.1111/j.1467-9299.2007.00650.x
  26. Arnstein SR. A ladder of citizen participation. J Am Inst Plann. 1969;35(4):216-224. doi:10.1080/01944366908977225
  27. Sienkiewicz D, van Lingen C. The Added Value of Patient Organisations. Brussels: European Patients' Forum (EPF); 2017.
  28. Sarrami-Foroushani P, Travaglia J, Debono D, Braithwaite J. Implementing strategies in consumer and community engagement in health care: results of a large-scale, scoping meta-review. BMC Health Serv Res. 2014;14:402. doi:10.1186/1472-6963-14-402
  29. de Leeuw E, Peters D. Nine questions to guide development and implementation of Health in All Policies. Health Promot Int. 2015;30(4):987-997. doi:10.1093/heapro/dau034
International Journal of Health Policy and Management
Volume 10, Issue 4
April 2021
Pages 176-180

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History

  • Receive Date: 07 December 2019
  • Revise Date: 02 March 2020
  • Accept Date: 03 March 2020
  • First Publish Date: 01 April 2021

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