Nothing about us, without us isn't a slogan. It's a floor.

I've sat in a lot of rooms over the years where the word ‘justice’ gets used so often it starts to lose its edges. People say it the way they say ‘wellbeing’ or ‘outcomes’, as if saying it is the same as doing it. So I want to be specific about what social justice actually looks like from where I sit, because I think when we get specific, it stops being a value statement on a slide and starts being something you can hold people to.

For me, social justice in health and social care starts with a simple, slightly uncomfortable question: who decided this, and who was in the room when they did? Most of the systems that shape disabled people's lives, that shape the lives of people who use mental health services, that shape what ‘good care’ is even allowed to mean, were built by people who will never have to live inside them. That's not a criticism of any individual. It's just true. And it means that however well intentioned a policy is, if it was designed without the people it affects, it is starting from a place of injustice before it's even published.

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A service can be efficient, well funded, and evidence based, and still be unjust, if the people it serves had no hand in shaping it.

I think that's the bit that gets missed. We talk about justice as though it's mainly about resources, about funding being distributed fairly, about access being equal. Those things matter enormously, don't get me wrong. But justice is also about power. It's about whether the people who carry the lived reality of a system get to influence how that system is built, not just consulted on it after the fact, not just invited to validate a decision that's already been made. There's a world of difference between being asked your opinion and being given actual power to change the outcome. I've experienced both, and I can tell you, your body knows the difference even before your head catches up.

This is why I've spent most of my working life in co-production. Not because it's a nice methodology, but because I think it is one of the only practical tools we have for closing that gap between the people who design systems and the people who live inside them. Done properly, co-production redistributes power. It says, you don't just get to hear from us, you get to be changed by what we tell you. And if you're not willing to be changed, genuinely changed, in your plans, your budgets, your timelines, then it isn't co-production. It's consultation wearing a nicer outfit.

I want to be honest about something else too. Justice work is exhausting when you are also the evidence. When you're a disabled person sitting on a panel about disability policy, or a person who has used mental health services advising on mental health strategy, you're not just doing a job, you're also carrying your own story into that room every single time. That takes something out of you that isn't accounted for in any work plan I've ever seen. So part of what social justice means to me, practically, is making sure the people doing this work are properly paid, properly supported, and not treated as a renewable resource you can just keep drawing on without consequence.

If your inclusion strategy depends on people's pain staying available on demand, it isn't inclusion. It's extraction.

I don't say any of this from a place of cynicism. If anything, the opposite. I've seen what happens when this is done right. I've watched a room change because someone with lived experience said the one sentence that nobody else in that meeting could have said, and watched a whole policy shift its shape because of it. I've watched grandparents and young carers and people who have spent years sectioned under the Mental Health Act sit at tables they were never meant to be invited to, and walk out having actually changed something. That's not a feel good story for me. That's evidence that justice is achievable, not just aspirational.

So when I talk about social justice, I'm not talking about a destination we're slowly travelling towards. I'm talking about a floor. A basic standard for whether a decision, a service, a policy, a piece of research, can even call itself legitimate. Did the people affected help build it. Were they paid and supported properly while they did. Did their involvement actually have the power to change the outcome, not just decorate it. If the answer to any of those is no, then whatever else that piece of work is, it isn't yet just. And I think we owe each other the honesty to say so, even when it's our own work we're looking at.