This critical commentary assesses the consequences and impact of forms of seemingly widespread, constructive and altruistic service user and carer participation (SUCP) within social work. In particular, and whilst drawing from Gramsci's understanding of hegemony and Levitas's critical interpretation of social exclusion, it is proposed that SUCP serves the interests of government, affiliated organizations, including those within social work and social care, and, perhaps more generally, the disparate needs generated by the neo-liberal-inspired social care market. Arguably, there are also related substantive aspects of SUCP that are problematic on ethical grounds -including the possibility that participation inadvertently increases social inequalities by justifying and promoting hegemonic agendas. Some suggestions are briefly made regarding how to move SUCP forward, including difficult questions that must be asked about whether or not SUCP can confront forms of structural disadvantage and oppression.