An Ambiguous Concept: On the Meanings of Co-production for Health Care Users and User Organizations?

Neither on the level of interactions between organizations nor on the level of servicing users, co-production has a fixed meaning. It is argued that there are different meanings that unfold once one looks at the impact of narratives such as consumerism, managerialism, or participatory governance. Altogether with the traditions of state-welfare, they simultaneously influence the modes and meanings of co-production in personal services. Taking up the example of modern healthcare systems and its hallmarks in Germany, it is shown that, therefore, uncertainty and ambiguity is the normalcy rather than the exception when it comes to define co-production. Role-expectations such as the “expert–patient” or the “citizen–consumer” have a liberating potential, but may likewise marginalize issues such as trust and the need for protection. User organizations are well challenged beyond their role of helping users to cope as good as possible with given role models of co-production.