"Ordinary people only": knowledge, representativeness and the publics of public participation in healthcare

Public involvement in healthcare is a prominent policy in countries across the economically developed world. A growing body of academic literature has focused on public participation, often presenting dichotomies between good and bad practice: between initiatives that offer empowerment and those constrained by consumerism, or between those which rely for recruitment on self-selecting members of the public, and those including a more broad-based, statistically representative group. In this paper I discuss the apparent tensions between differing rationales for participation, relating recent discussions about the nature of representation in public involvement to parallel writings about the contribution of laypeople’s expertise and experience. In the academic literature, there is, I suggest, a thin line between democratic justifications for involvement, suggesting a representative role for involved publics, and technocratic ideas about the potential ‘expert’ contributions of particular subgroups of the public. Analysing recent policy documents on participation in healthcare in England, I seek moreover to show how contemporary policy transcends both categories, demanding complex roles of involved publics which invoke various qualities seen as important in governing the interface between state and society. I relate this to social-theoretical perspectives on the relationship between governmental authority and citizens in late-modern society.

The grey zone: the 'ordinary' violence of extraordinary times

The article analyses the 'ordinary' violence of revolutionary politics, particularly acts of gendered and sexual violence that tend to be neglected in the face of the 'extraordinariness' of political terror. Focusing on the extreme left Naxalbari movement of West Bengal, it points to those morally ambiguous 'grey zones' that confound the rigid distinctions between victim and victimizer in insurrectionary politics. Public and private recollections of sexual and gender-based injuries by women activists point to the complex intermeshing of different forms of violence (everyday, political, structural, symbolic) across 'safe' and 'unsafe' spaces, 'public' and 'private' worlds, and communities of trust and those of betrayal. In making sense of these memories and their largely secret or 'untellable' nature, the article places sexual violence on a continuum of multiple and interrelated forces that are both overt and symbolic, and include a society's ways of mourning some forms of violence and silencing others. The idea of a continuum explores the 'greyness' of violence as the very object of anthropological inquiry.