Why is Lived Experience Absent from Social Security Policymaking?

Today we’re reposting this excellent blog that was published on the UK social policy blog, because of the insights it offers into the ways in which welfare recipients could be supported to participate in welfare policymaking. Given current interest in stigma power in the wake of the Robodebt Royal Commission the blog’s insights are salient to thinking about the ways in which lived experience can be embedded in future policy making in Australia.

In the UK, there is a clear imperative to facilitate greater participation in contemporary public policy making in part to address a purported democratic deficit, both locally and nationally. This is most evident in the context of health policy, where a logic of ‘knowledge transfer’ continues to dominate. For example, Gloucestershire NHS state “Experts by Experience are people who have personal knowledge of our services, either through their own use of those services, or through caring for someone else. They help us better understand and meet the needs of our service users and their carer’s, and assist us to involve and learn from people who know most about our services through receiving them,”. At a national level, the Care Quality Commission (the independent regulator of health and adult social care in England) routinely involves ‘the public in inspections and activities’.

Conversely, there is little if any involvement of similar ‘experts by experience’ in the context of social security policy making (although Scotland has started to make efforts to incorporate lived experience in this area). The social security policy arena tends to be dominated by a logic of ‘arbitration and oversight’ rather than knowledge transfer. Yet despite the relative similarity in terms of purportedly caring for the end user through effective policy provision, it would appear that health has far more readily incorporated lived experiences into its decision-making processes than social security. Why is it the case that service users are often involved in health policy/delivery but not in social security policy/delivery, which is clearly an allied area of state provision? 

We contend that there are three primary ways of understanding this discrepancy. First, the absence of lived experience is partially explained by a lack of effective accountability mechanisms countervailing the state’s influence on social security policy. Second, the social imaginary which constructs patients is fundamentally different from the one that constructs out-of-work beneficiaries of means-tested social security. Third, there is a strong social stigma attached to the label ‘out-of-work beneficiary’ that functions to undermines the scope for solidarity and collective action around reclaiming and resisting these negative social imaginaries which stigmatise out-of-work beneficiaries.

In terms of countervailing powers, our primary claim is that the field of power for social security policymaking is dominated by the state, limiting the ability of social security beneficiaries to forge power blocs to countervail the state. This is because the state creates the practices that structure social security systems and has successfully managed to avoid the identification of any democratic deficit in the social security policy field. Health service users, by contrast, have more opportunities to form power blocs because of key differences in the structure of the health policy field, such as the presence of healthcare professionals (with a recognised form of accreditation and expertise) who might hold government to account. 

In terms of the social imaginary, the institutional configurations which marginalise the voices of the beneficiaries of social security and which simultaneously incorporate the voices of patients are ‘ideationally embedded’. They are characterised by different social imaginaries of who social security beneficiaries and who patients are. Crucially, for Somers and Block, not all voices are created equal, some hold a certain comparative advantage within the epistemic terrain that currently organises specific social forms. This means that some voices fit more easily with each other and with existing institutions, reflecting the ongoing struggles for hegemony within any given field. At present, the ideational embedding of beneficiaries is as active citizens, this views the claimant as someone who needs to earn their rights as citizens through becoming a productive subject. This imaginary of claimants as active citizens (rather than say as patients) works positively in the state’s interest, functioning to limit and constrain access to social security. Dislodging the dominant logics of social security becomes difficult without also changing the institutions that are sustained by those ideas.

In terms of stigma, there is a fundamental paradox at the heart of social security which constrains resistance. This has been compounded by policy changes which undermine the capacity for resistance. This stigmatisation of social security beneficiaries is rooted in notions of dependent poverty (due to lower work effort – skivers). Conversely, evidence suggests the actual experience of receiving social security is completely divorced from this caricature of the work-shy, long-term claimant; and yet this characterisation continues to dominate the social rationality of social security policy. Moreover, the identity of claimants is so transitory for most people that it is simply rather unlikely to become a durable marker of their sense of self. In contrast, the most effective organising around health-related stigma has been around chronic conditions in which the ‘spoiled identity’ is durable in a way that creates a shared experience among otherwise disparate groups.

Contemporary social security policy changes, predicated upon an activation model have undermined the space for resistance, while austerity and the digitalisation of social security have also stripped away the sites around which such resistance could form. This comes through clearly in Koch and Reeves’ work on Universal Credit where one interviewee – who was also an activist – noted that she had to be ‘careful’ because she feared activism might lead to a sanction. It was not always like this, she reminisced, ‘back in the 1990s, you could be on the dole and use your benefits money to do political activism, but today you can’t do that, you cannot do that anymore. Activism is now a privilege of the middle classes’.

The three issues we describe in this blog all overlap, creating a stigmatised and structurally marginalised service user position located within a field dominated by powerful and largely unaccountable state actors. If real change is to be effected, and if social security beneficiaries are to be involved in tackling the democratic deficit in social security policy and practice, it seems that the best place to contribute is in helping develop a national, grassroots social security policy movement (e.g. Poverty Truth Commissions), perhaps mimicking the principles embedded in Scotland’s lived experience panel, which helps them design social security policy.

Social welfare needs to be reclaimed as something which is positive which can be used directly to support people. Social welfare provision should be an opportunity to lessen the social reproduction of inequality. An essential stage in reclaiming the spoiled identity of the welfare recipient is finding meaningful ways in which people might participate in welfare policymaking. 

About the authors

Ewen Speed is Professor of Medical Sociology at the University of Essex.

Aaron Reeves is Professor of Sociology and Social Policy at the University of Oxford.

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Power to Persuade