Rick Henderson and Mike Pochin (2001): A Right Result? Advocacy, Justice and Empowerment. Bristol: Policy Press, pp. 165.
As Henderson and Pochin point out in the introduction to their book, recent years have seen the concept of advocacy given increasing prominence in central and local government policy in the UK. It made an appearance in local community care and long-stay hospital closure plans. It features in reforms to the health service in England and Wales, in the form of the Patient Advocacy and Liaison Services (DoH 2000), while proposed changes to the mental health system also accord a key role to service users’ advocates. In addition, Valuing People , central government’s proposals on the future strategy for people with learning disabilities, promised the widespread development of advocacy services (DoH 2001). Advocacy, traditionally located on the margins of state activity in the UK, is experiencing something of an attempt to shift it into mainstream policy and service provision. This makes it a significant time to review the core values and practices that have distinguished advocacy from other forms of professional and voluntary intervention and to explore how these may be preserved and developed in the contemporary context.
Henderson and Pochin have seized the opportunity to produce a timely book that focuses on the dilemmas facing the advocacy movement in the UK but which will have resonance with experiences in may other countries of the world. A set of three basic themes are explored and revisited in one form or another throughout. The first deals with the irreducible elements that are argued to be central to good advocacy practice. The second concerns the autonomy of advocacy and the ever-present danger that its key values and practices may be compromised by a variety of external demands and pressures. These might include, for example, conditions attached to funding and attempts to incorporate it into mainstream service organisation and culture. The third theme is about the need for the advocacy movement itself to take charge of setting its own house in order. While the authors find a very great deal to celebrate about advocacy, they also argue that the movement itself must take the initiative and address a range of issues including quality standards. They suggest that it is both necessary and possible for those within the movement, to develop effective and ethically sound systems to organise, monitor and evaluate what they do.
A Right Result? concentrates on third party advocacy. While the authors acknowledge the importance of self-advocacy, they point to a substantial, existing literature on this topic (Goodley 2000; Simons 1992). Like others before them (see, for example, Atkinson 1999), Henderson and Pochin begin by discussing the problem of definition. They choose the term ‘partner’ rather than ‘user’ or ‘client’ for the person who seeks or is offered advocacy. The Practice itself is described as ‘the process of identifying with and representing a person’s views and concerns, in order to secure enhanced rights and entitlements, undertaken by someone who has little or no conflict of interest’. On the basis of this definition, they critically review a range of approaches and identify their distinguishing features. In subsequent chapters, they consider key problems currently being faced by advocacy schemes in the UK; advocacy outcomes and approaches to measuring them; quality standards; and training. The concluding section offers a summary of the major debates in the book.
Henderson and Pochin provide an accessible and articulate account of approaches to third party advocacy and of the tensions surrounding it in the contemporary UK context that can be used beyond this immediate national context, not least because their discussion is illustrated with practical examples. Key points are clearly summarised at regular intervals. While the authors’ argument is measured, their strong commitment to advocacy as ‘a force for good’ is apparent throughout. One of the strengths of this book is that it is written by two experienced insiders who are able to behave as critical friends to a movement which, they suggest, can be too inward-looking and fragmented. They also challenge others involved to deal with the fact that good intentions on the part of advocates or the schemes with which they are linked, do not always guarantee good outcomes from their partners' perspectives. A Right Result? provides a very good introduction to third party advocacy and to the frequently inspirational values that drive it. The authors offer an extremely helpful review of the challenges faced by the advocacy movement and the dimensions of its organisation and practice that render it fragile and vulnerable. In addition, they propose credible ways forward that they believe may enable it to ‘marshal its strengths in order to counter its weaknesses’.
Their detailed discussion of many issues is impressive. It is enlivening to read their accounts of the both subtle and dramatic ways that people's lives may be enriched when an advocate and a partner work together effectively. I found their examination of the ways in which organisational contexts and cultures enhance or undermine the principles of advocacy, informative and convincing. The use of Patient Advocacy and Liaison Services (PALS) in the health service, as an illustration, is an interesting example, as is their review of the impact of the performance management systems introduced as part of the New Labour government’s modernisation agenda.
My main reservation about this book is that its organisation is in some respects, slightly confusing. This, in turn, seems to lead to repetition in a small number of areas. A slight re-organisation and editing of material might have enabled clearer and stronger links to be made between related areas of debate.
This book is likely to prove useful to those with a direct interest in advocacy. In addition, it will be of value to many other practitioners, students and academics who are concerned with the variety of ways in which people may be supported to secure enhanced rights. While the book focuses to a significant extent on the UK context, it also draws on some European and American literature. Despite its UK focus, I suspect that a good deal of the authors’ material has a much more universal appeal and application.
Atkinson, D. 1999: Advocacy: A Review. Brighton: Pavilion Publishing for the Joseph Rowntree Foundation.
DoH (Department of Health) 2000: The NHS Plan. A Plan for Investment. London: DoH.
DoH (Department of Health) 2001: Valuing People: A Strategy for Learning Disability for the 21st Century. London: DoH.
Goodley, D 2000: Self-Advocacy in the Lives of People with Learning Difficulties. Buckingham: Open University Press.
Simons, K. 1992: Sticking up for Yourself: Self-advocacy and People with Learning Difficulties. York: Joseph Rowntree Foundation.
Dr Janet Read
University of Warwick
School of Health and Social Studies
Tel: ++44 24 7652 4140