Two nights a week, 16-year-old David Cooke heads for a sexual health clinic straight after school. He serves snacks and drinks and chats to the dozen young people - half of them boys - who drop in to each open session.
Cooke's readiness to volunteer is remarkable, not merely because he is a young man in a setting where young men are notoriously scarce, but because the clinic is in Little Hulton, Salford - an area with one of the highest rates of teenage pregnancy in the north-west.
"We wanted to look at ways of trying to reach young men who traditionally don't attend sexual health clinics," says Julie Deebank, an outreach worker and manager of the Salford Brook advisory centre. Consequently, the planning and design of the clinic involved young people from the outset.
The centre's success is being recognised today when it is named a winner in the public involvement awards run by the Institute for Public Policy Research (IPPR) and supported by the Guardian. The Salford scheme is praised for excellence in young people's involvement. The other three categories are health, general and "e-involvement".
The judges commended the control and influence young people have had at the sexual health centre. Deebank used focus groups of young men - taking in excluded groups in prison and young offenders' institutions - to find the sort of service they wanted. "Young men said they didn't want it to be associated with health," she says. "They saw sex as fun and wanted it to be more like a youth club."
Indeed, the centre appears in many ways very like a youth club. Where other projects would have waiting rooms with plastic chairs and dog-eared magazines, there is a pool table, videos, a computer room and a cafe.
The centre also set up a 15-strong young people's management group -many in their early teens - which meets Deebank monthly to discuss how the project should be run. Recruited through outreach work and word of mouth, the group has been involved in recruiting male counsellors, developing a volunteer policy and producing a newsletter for young people in the Salford and Trafford health authority area. Half the group, including Cooke, volunteer in the centre and have been trained to run peer counselling drop-ins.
About 90% of those using the centre are under 16. "It's all confidential," says Cooke. "So if I saw someone who had come along to the clinic at school, I'd keep quiet." He joined the group because he was given the chance to join in. "I wanted to do something helpful. We were treated like adults and our opinions were listened to. Anyone who comes in knows we're not looking down on them."
Deebank has been struck by how many young men have wanted someone to talk to. Most come in and ask for condoms. "But once we start the interview process," she says, "it emerges that many are having sex because they've nothing else to do, or because their friends are, or they're anxious that girls will laugh at them if they don't. They don't feel happy about it."
The judges agreed that Salford Brook was a model of good practice and had the right ingredients to meet its goal of reducing teenage pregnancies. The project met the judging criteria of inclusion, involving groups normally excluded from decision-making, and having a strong community focus.
The panel was also looking for projects that showed how public involvement had influenced the delivery of a service, or had changed policy within an organisation, and how people had been given new responsibilities.
Margaret Clark, a member of the Alzheimer's Society's consumer advisory group, believes that her organisation has done just that. The society is another award winner. "To be able to do something positive is really helpful," she says. As a carer for a relative and a friend with Alzheimer's, Clark has first-hand knowledge of the disease and the implications for people who have it. Such knowledge is put to constructive use through the group, which places the values of people with dementia and their carers at the core of setting the research agenda, awarding grants and assessing outcomes. The group, started in 1999, incorporates 10 to 15 "consumers" from each of the society's 12 regions - 136 in total. Aged between 23 and 92, they are recruited through the charity's newsletter and website and all have experience of dementia, either personally or as a carer.
As a result, the society's research is less esoteric and better focused on issues of quality of life. In turn, the shift has attracted a big increase in funding, as funders are able to appreciate the practical applications of research. Such a commitment to changing the culture of the organisation has made the Alzheimer's Society winner of the award for excellence in public involvement in health.
The involvement process has "broken down that traditional divide between doctors and patients," says William Peberdy, a carer and coordinator of the society. "It recognises the carer as a verbal extension of the patient. The fact that we're there 25 hours a day, while they see a doctor only once every few weeks, gives us an intimate knowledge of the disease."
Particularly impressive is the charity's willingness to take a risk by handing over the decision-making process. Richard Harvey, its director of research, faced considerable reticence from medical and scientific experts about hurling the organisation head first into public involvement. "They certainly needed some persuasion that this was the right way forward," he says, admitting that the process is "one big experiment". But the group is "amazing", he insists. "They've brought important skills from other backgrounds to the process."
Skills and ideas are also being given a platform by the Essex Grid for Learning, a curriculum-based website for people learning and teaching in Essex - earning it the award for excellence in e-involvement. Between 70% and 80% of the content has been produced by local contributors, and the scheme targets those without internet access in their own homes.
Rosi Somerville, one of the award judges and national project coordinator of the improvement and development agency, which supports the e-involvement award, says the Essex scheme has successfully reached out to local people. "It encouraged their ideas so that the site's growth and improvement belonged to them."
The Co-operative Bank takes the general award for excellence in public involvement, for asking customers to help determine its ethical investment policy. Account holders have been asked to nominate issues of concern and comment on those already raised, such as arms trading, animal testing and genetic modification. All the bank's 2m customers will be given the chance to vote on issues gleaned from this research about where they do and do not want the Co-op to invest. Every branch will become a polling station for six weeks and the votes will form a new ethical policy, to be launched next April.
The policy will almost certainly oblige the bank to exclude several existing business customers which conflict with account holders' ethics. "We'll be faced with difficult decisions - particularly in the GM biotechnology industry," says Barry Clavin, the bank's ethical policy manager. "But we'll gain new markets by tapping into our customers' ideas. It is possible to be profitable and ethical."
Clavin says the bank is particularly keen to solicit the votes of customers aged under 18. "We're very interested to see if this group shows the same level of voter apathy as the general election, or if young people have alternative ways of being political."
Matthew Taylor, the IPPR director and one of the awards judges, says that rewarding examples of good practice is an attempt to explain that it works. "There continues to be too much cynicism about whether consultation delivers," he says. "Doing it right is hard. Bad public consultation is worse than no public consultation. It involves resources, risk and commitment. People who win these awards are not Whitehall people and not otherwise getting plaudits. We wanted to celebrate their work."
Despite the success of local authorities in last year's awards, this year's judges felt local government entries were not very strong. "It's a matter of concern that local authority practice seems to be stood still or even sliding backward," says Taylor.
He believes that "consultation burn-out" may be partly to blame, as councils have become overwhelmed by requirements for consultation. "But I also fear that local authorities often try to put their energy into areas where the public are least motivated. Things would be better if they concentrated their energies where they really matter."
