Clients, service users and citizens

Community Care has been running an interesting survey on what workers and people who use services think the latter should be referred to as. Andy McNicoll’s interesting blog about it is here. A third of workers in social care think that “client” is best, with “service user” coming in a close second. “Person” and “person who uses services” made a showing, with “customer” and “patient” (thankfully) in the minority, although a little more popular than “citizen” at 1%. Community Care didn’t get as many responses from people who use services as they did from workers, but those who did respond showed a strong preference for “service user” over “client”. If that survey could be repeated with a bigger sample size, it is a good reason to ditch “client” for good.

What I found most interesting was the reasons given by workers for preferring “client”, which tended to be about its connotations of professionalism (for them) and comparisons with other (higher status?) interactions, such as solicitor/ client and financial advisor/ client relationships. Some also felt that “client” was more honest and accurate about the nature of the relationship, whereas others thought it ( and “customer”) had positive implications around the individual’s choice.

There are problems with all of the terms. “Client” and “customer” are taken from commercial transactions in which someone purchases something from a professional, so there is no sense of a relationship of equals, in which both parties contribute to the intervention and have some responsibility for the outcome. In other words, no sense of “co-production”. Trying to address this is hard: “co-producer” is into doublespeak territory – a bit like a coffee shop calling its modestly-paid employees “partners” (which works fine, however, for John Lewis, because its workforce really does have a partnership with them and shares in their profits).

“Service user” brings a similar problem: it says that the individual uses something produced by someone else. Adding “person” (person who uses services) is at least a reminder that the individual is a person, but is rather long-winded and has no more sense of “participant” or “producer” as well as consumer. Of course, with co-production far from embedded in social care, it does for the time being have accuracy: perhaps better terms will be generated by services and enterprises which are genuinely mutually-owned and controlled by workers and people with support needs, like this one, which could justifiably simply refer to its “partners”, “members” or “owners”.

“Citizen” addresses some of these problems, but is not commonly understood by people to mean someone in need of support.

Does any of this matter? It matters a lot less than what an interaction actually feels like. But it does give an interesting insight into how workers see what they do. And, whilst political correctness can be self-defeating, particularly when the language is far ahead of the reality, changing the way we speak can sometimes start to change the way we think and act.

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