OPINION: Thinkpiece - We need latter day martyrs to fight the cause

Simon Lawton-Smith, head of public affairs at national mental health charity Maca

Remember suffragette Emily Davison? In June 1913, she ran out in front of the field in the Derby and grabbed the reins of the King's horse, Anmer.

She suffered fatal head injuries and died - a martyr to the cause of votes for women.

I'm not for a second suggesting this should be emulated by campaigners today. But the fact is, her act is remembered 90 years on as a seminal moment in the struggle for women to have their voices heard. Emily Davison represented the cutting edge of this struggle.

Fast forward to June 2003, and what of the voice of the health service user? We have a seemingly endless list of initiatives, the spanking new Commission for Patient and Public Involvement in Health for one. They are welcome, their heart is in the right place and we should allow them to settle before judging them. But they are "top-down". Not one, so far as I know, was initiated by service users.

Nowhere is it more important to ensure that the rhetoric of patient-centred care becomes reality than in mental health, where the voice of the service user has been ignored for decades if not centuries. Paul Boateng may once have opined: "Effective mental health service provision can only be delivered if users have played a key part in their design". But when I quote this to service users now, the response is usually a hollow laugh.

I believe the third sector has a responsibility to be at the cutting edge of service user empowerment. We must support people prepared to challenge the conservatism of Whitehall - noisy and passionate people who are going to be a thorn in the side of officialdom. They may not always be popular, pragmatic, or even (dare I say it?) right all the time. But they will make service user empowerment a reality.

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