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22 JULY 2009
NO 1464
Advocacy
Practising caseworkers are able to draw on a
number of tools and techniques which may help to ensure that service
users gain the maximum benefit from their intervention. Many
professionals regard the advocacy role as a proper and relevant part of
their professional life. It is common for social workers to challenge
other agencies, such as a health authority, the Benefits Agency or a
housing department. They may also find themselves advocating for a user
within their own agency. Nurses have always felt that they are the
patient's advocate when challenging doctors, especially where medical
decisions have not taken account of a patient's lifestyle and personal
needs or wishes.
There is a school of thought which questions the ability of professional
service providers to provide effective advocacy. A number ofwriters have
emphasized the need for absolute independence and refer to the many
constraints within which professionals commonly work. They point to the
need to follow agency procedures, to satisfy a manager that this is good
use of their time and to remain credible with colleagues.
If the advocacy task involves challenging an employer or a colleague, it
might be extremely difficult for them to pursue the cause with absolute
loyalty to their partner. Even where the task involves challenging
another professional agency, there may well be formal or informal
reciprocal arrangements which hinder the advocacy role (Ivers 1994; Sang
and O'Brien 1984).
However, the expanding social work role as care broker has caused some
writers to think again and to suggest that the volunteer citizen
advocacy role suffers from a fundamental weakness which has to do with
the variety of skills and roles which it attempts to embrace (Bateman
1995). This writer firmly supports the idea that professionals can learn
advocacy skills and suggests that it is an appropriate role for doctors,
social workers, nurses, advice workers, members of the clergy, and
housing and education officials.
Most professional organizations have been slow to define the advocacy
role for their members, apart from the legal profession of course. The
other exception is nursing, where the United Kingdom Code of
Professional Conduct and the International Council of Nurses clearly
expect nurses to act as advocates for their patients. This role was
confirmed during interviews with nurses who point out their traditional
role of advocate where patients might need to challenge the medical
profession or community service providers (Ivers 1994). However, Bateman
(1995) explains the difficulties faced by nurses when they attempt to
challenge the power of a high status doctor.
In an evaluative study of a citizen advocacy scheme, it appeared that
even if paid staff were aware that elderly people in their care had
needs outside of those being provided, they might not have been able to
establish what those needs were or to spend the necessary time in
pursuing solutions (Ivers 1994).
The complex role of an advocate is remarked upon by Wolfensberger
(1977), who divided it into two fairly distinct elements. One is being
able to help their partner gain access to services and benefits, and the
other is to become a warm, caring and supporting friend. If this dual
role is accepted then professional advocates might well find themselves
in some difficulties. The second element could extend the professional
role into something unwieldy which might interfere with their commitment
to other service users and to contractual requirements.
VERA IVERS
Ivers, V. (1988) Advocacy. Chapter in Craig, Y.J. (1988). Advocacy, Counselling and Mediation in Casework. London: Jessica Kingsley Publishers. 27-28.
