The politics of representation versus the politics of outcome: The role of research evidence in developing health and social care policy

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• The politics of representation versus the
  politics of outcome The role of research
  evidence in developing health and social care
  policy
• Dr Karl Atkin

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Introduction

• Currently face several dilemmas
• how can we avoid descriptive and essentalised
  accounts?
• make sense of differences without use of
  stereotypes and myths?
• develop a commitment to using findings to improve
  outcomes
• emphasise relevance to mainstream debates
• Familiar problems, but failure to engage has
  contributed to flawed understanding,
  inappropriate responses and wasted resources
• Introduce key themes that will enable us to make
  sense of challenges and develop strategy
• the usefulness of institutional racism
• making sense of difference and diversity
• using evidence to initiate change

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Ignoring and misrepresenting difference and
diversity

• Disregard of religious, linguistic and cultural
  needs of minority ethnic populations
• Assumptions that policies and procedures are
  equally appropriate for everyone
• Difference used against minority ethnic
  populations
• Deviant and unsatisfactory lifestyles
• Muslim populations and pre-natal diagnosis
• Inappropriate and simplistic generalisations
• Treatment of pain

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Making sense of ethnicity and diversity

• Ethnicity is not neutral term and embodies
  various idea
• Ethnic and cultural identities helps people make
  sense of who they are
• Such identities are constructed within the
  context of social relations
• Similarities and differences with general
  population
• Ethnicity is not only explanation for
  disadvantage or how people make sense of who they
  are
• Gender, age and social class can be equally
  important

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Community Cohesion

• An alternative way of looking at diversity and
  difference?
• a community of communities (Parekh Commission,
  2000)
• a failure to integrate (Ousley, 2001 Cantle,
  2001)
• existential angst (Royal Society of Arts, 2005)
• Britishness as a solution?
• to be British means that we respect the laws,
  the democratic political structures, and give our
  allegiance to the State but to be British
  does not mean assimilation into a common culture
  so that original identities are lost (Home
  Office, 2004)
• Does concept undermines notion of difference as
  the basis for policy-making or offer a solution
  to managing a multi-cultural state?

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Achieving change and improving outcomes

• Critical emphasis is understandable but can do
  little to transform policy and practice
• Disillusionment of minority ethnic populations
• Disempowerment of practitioners
• Move beyond the politics of recognition and focus
  on achieving sustaining outcomes
• Different approaches to research
• greater theoretical sophistication
• knowledge and systematic reviews
• need to know what works and why
• better understanding of practitioners and
  organisation of service provision, rather than
  focus on experience of minority ethnic
  populations

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Conclusion

• Our work implicates methodological, ethical and
  political issues
• Requires greater theoretical sensitivity and more
  of a focus on practical intent
• recognising diversity and difference
• making sense of the complex nature of ethnicity
• commitment to change and improved outcomes