Almost exactly two years ago, I wrote a post about the word we should use for the people who use government services. Its opening paragraph was:

There used to be benefit claimants.  There used to be passengers.  There used to be taxpayers.  Now there are customers (and patients, who seem, so far, to have survived the cull).

Now I discover it may be all over for patients too.

Yesterday, Patient Opinion ran a Yorkshire and Humber Event, and triggered a fascinating twitter conversation between Patient Opinion itself, Stephen Collins in Australia and Justin Kerr-Stevens somewhere between the two.  The blow by blow exchange – as near as I can reconstruct it – is below the fold, but the essence of it was Stephen’s challenge:

Perhaps the notion of patients as “users” is a telling factor. Are they not *people*?

Well of course they are – we are.  And Stephen went on to link to I Am Not a User, a site which proclaims the importance of talking about ‘people’. Its author links in turn to a marvellous polemic by Don Norman:

If we are designing for people, why not call them that: people, a person, or perhaps humans. But no, we distance ourselves from the people for whom we design by giving them descriptive and somewhat degrading names, such as customer, consumer, or user. Customer – you know, someone who pays the bills. Consumer – one who consumes. User, or even worse, end user – the person who pushes the buttons, clicks the mouse, and keeps getting confused. […]

People are rich, complex beings. They use our devices with specific goals, motives, and agendas. Often they work with – or against – others. A label such as customer, consumer or user ignores this rich structure of abilities, motives, and social structures.

It’s a great challenge, but I am not sure whether to accept it.  My instincts are against linguistic minimalism.  Different words convey different meanings because sometimes there are different things we want to say. Using one word for everything feels as though it must undercut our powers of communication. Describing some people in terms of the thing they are doing or being which distinguish them at that moment from people in general must surely add to understanding rather than detracting from it. But that, of course, presupposes that those distinctions make a difference, and the counter argument must be that, in some important sense, they don’t.

In practical terms, it would take a lot of effort to expunge all those words from our vocabulary and would result in some pretty odd sounding constructions.  So it’s not worth doing – and won’t get done – unless there is an overwhelmingly powerful argument for change.  I am not yet seeing that argument, so I plan to stick with ‘customers’ for a while longer for the reasons  set out in that post two years ago.  But perhaps that’s because I am a dinosaur person.


  1. “People” won’t work and isn’t the answer. Of course it’s right at one level and whatever labels we use for whatever reasons shouldn’t obscure the fact that they/we are people. But it’s not helpful, although alluring. Fact is, as PS says in his post, we’re not just ‘people’ in our various interactions and relationships with government. We are lots of different things and sometimes it’s actually perfectly appropriate to be defined in a specific role – customer, user, patient, citizen. They all mean something – or should – and they should signal what we might expect in terms of the way people wearing those labels should expect to be treated.

    The argument about dropping labels is false I think. Labels are both good and necessary. But if labels are used to distract and to be used devoid of any meaning (with resulting expectations from those at the other end), then we have a problem, for sure. But it’s not a problem likely to be solved by trying to find the once and future label we can use always and everywhere.

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