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Health services: who are the best advocates for children?
  1. E Webb
  1. Department of Child Health, University of Wales College of Medicine, Cardiff UK.
  1. Correspondence to:
    Dr E Webb, Senior Lecturer, Department of Child Health, University of Wales College of Medicine, Cardiff CF14 4XN, UK

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“Advocacy is not about saying what’s best for a child or young person but about enabling that child or young person to come to informed decisions about matters which are affecting their lives”

This quotation comes from the evidence given by the Children’s Society in Wales to the Carlisle review into safeguards for children and young people treated and cared for by the NHS in Wales. This usage of the term is now commonplace in local authorities and voluntary agencies, in which advocacy is a process firmly focused at an individual level. It is at odds with the definitions provided in the Oxford English Dictionary:

  • Advocacy: “the function of an advocate”.

  • Advocate: “one who pleads, intercedes, or speaks for another”.

This shift in usage leads is not only confusing, but devalues the process of speaking on behalf of others. For the purposes of this paper I will stick to the Oxford English Dictionary definition of advocacy and use the somewhat unsatisfactory term of “self advocacy” to describe the process by which individuals or groups are supported and empowered to speak for themselves.

SELF ADVOCACY

Individual advocacy

Self advocacy is clearly desirable if it is achievable. The successful self advocacy of children requires overcoming the cultural and institutional barriers children face in getting heard in a society in which the non-participation of children in decision making is the norm.

The voluntary sector has developed great skills in the area of supporting the self advocacy of older children and young people. In Wales, until recently, the Children’s Society was the largest provider of such services, providing support to children and young people looked after by local authorities, those who had left care, child “runaways”, those who came into child protection systems, and to the wider group of children in need who were receiving help and …

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