Introduction

Since the 1970s, consultation with service users has become an accepted feature of both policy making and professional practice. This reflects the impact of grassroots social movements on ways of thinking about welfare in Britain (Williams, 1999). The first part of this chapter locates this growth in consultation practice in a broader social and political context – the crisis of legitimacy in public services and the welfare state (Needham, 2003), and the crisis in the legitimacy of expert knowledge that characterises social life in the age of modernity. The chapter then reviews the nature of policy making, noting the limitations of the rationalistic What Works agenda and similar academic models of the policy-making process. The third part of the chapter summarises two main approaches to the generation of knowledge about the social world. Finally, the chapter illustrates the strengths of interpretivist social research by summarising some of its key contributions to the understanding of health, illness and disability. The social model of disability and the critique of rehabilitation that it has generated are presented as examples of the way that social research is more likely to influence overall policy trajectories than the design of specific policies (Graham, 2002).

The changing context of knowledge: the welfare state meets modernity

A key characteristic of what social historians describe as the late modern period is that a more educated, quizzical and cynical public and media question the truthfulness, evidential status and credibility of all forms of knowledge (La Tour, 1993). Claims to know the ‘truth’ about the social world and the status of experts were profoundly shaken by two developments. First, the women’s, disability and environmental movements, collectively known as the ‘new social movements’ (Young, 1990), developed radical critiques of the professional paternalism that had underpinned so much of the post-war welfare state. These critiques developed into broader debates about scientific truthfulness and the relationship of science and expert knowledge to public policy making and the public interest (Beck, 1992). Second, the neoliberalism of Thatcherism and Reaganism prioritised the individual and the consumer and extolled the virtues of small government. Together, these developments created a crisis of legitimacy in the traditional European welfare state (Commission on Social Justice, 1994; NESC, 2005).