Manifesto for change
It seems fitting that any book which presents the reader with the challenges facing healthcare professionals in their role in working with people who may be stigmatised should also present a synthesis of the key issues addressed, together with suggestions for future practice. A manifesto is traditionally viewed as some form of public declaration of policy, but in no way do we wish to prescribe. It is for each professional to reflect on the issues which have been raised in this book and to explore whether their practice could incorporate a different and more equitable approach to those people experiencing physical or emotional illness or disability, or engaged in alternative lifestyles. The manifesto is presented as our ideas for the ways in which practice may be taken forward in a number of areas, including education, research and development and individual professional practice. A number of common themes have emerged from previous chapters in this book and these have helped to identify key issues for reflection.
In any manifesto the declaration of intent will usually outline the desired goal, or end position, that the manifesto seeks to attain in a particular time-frame. This manifesto is no different. However, in declaring a policy for change we hope to incorporate two considerations that are often missing in documents that drive a course of action. The first is concerned with understanding the current position relating to stigma and social exclusion, and this appreciation is not only rooted in a historical context but is also grounded in contemporary practice. Through a close examination of the chapters of this book we have identified the emergent themes that underpin the practice areas. This exploration has located the basis of any change policy at the clinical interface and will, therefore, set the manifesto in a realistic context. This will help answer a central question relating to any manifesto development, that of ‘from what to what?’. The second consideration is, to some extent, the easier to address. Manifestos can be