1.5 Understanding personalisation: the service user
In the 1960s and 1970s, the whole of British society went through a process of dropping its traditional deference to ‘authority’ of one kind or another. There was also growing concern about inequality and the potential for professional power to be wielded in ways that oppressed the very people the professionals were employed to provide a service to.
The picture of health care provided to Margaret Scally in the 1980s and early 1990s was not so very different from social care in (for example) older people’s or children's homes in the same era. So the term ‘client’, which had once seemed to centre on the essential and unique worth of each individual, became discredited. Resource constraints contributed to an understanding that clients were not equal in power to social workers or social care providers; unlike the client of a lawyer, they could not ‘sack’ them.
In the 1970s ‘disabled clients’ – following the example of the civil rights movement against racism in the USA – began to assert disability rights. Disability rights groups argued that the problem lay with the way that society responds to people with disabilities: with individual prejudice, institutional discrimination and social environments that act to exclude rather than include. This view came to be known as the ‘ social model of disability ’, which contrasts with the individual or ‘ medical model ’, which sees these barriers as relating to the individual and his or her disability.
In the UK the Independent Living Movement , which has its roots in the 1960s US civil rights and consumer movements, led the way in enabling people with disabilities to move from institutional care and towards a model where they, rather than professionals, were making decisions about their care.
Activity 1.5: ‘Medical model’ or ‘social model’?
The statements below are based on either the ‘medical’ or the ‘social’ model of disability. Drag each one into the model that you think the statement most closely represents. When you drag one, a new one appears. Once you’ve placed each factor, review your selections. You can use the ‘Reset’ button to try again. When you’re happy with your selections, use the ‘OK’ button to find out how you did.
Use your learning log to record any reflections about your experiences as a service user and/or provider of how these models influence health and social care services.