The Social Audit Agenda — Primary Health Care in a Stakeholder Society

Abstract

This paper develops the conceptual and paradigmatic issues of social audit as groundwork for possible implementation within public services focusing particularly on the primary healthcare sector. Early sections of the paper consider arguments as to why social audit may be particularly relevant to the contemporary health care environment as well as some of the possible obstacles and reservations to its implementation. Alternative approaches to social audit are then discussed. A polyvocal citizenship perspective (PCP) which enables the direct participation of stakeholders is adopted. This is grounded in the concepts of reciprocal interest, empowerment evaluation and accountability. A social accounting and audit model is proposed which places emphasis on a system of iterative and interactive process of stakeholder dialogue, feedback and evaluation. Lastly, some prototypical ideas for social audit based on the Patients' Charter are discussed.