Rikki Dean, John Boswell and Graham Smith analyse an attempt to design a systems-oriented democratic innovation: the NHS Citizen initiative. They write that, while the initiative pioneered some cutting-edge participatory design, it failed to resolve well-known obstacles to institutionalisation. They argue that similar projects must evolve strategies to meet such challenges.
When discussing the EU referendum it’s become fashionable to criticise David Cameron for taking a dangerous gamble with the UK’s prosperity for narrow political advantage. The argument runs that the decision on whether to stay in or exit the EU is so complex that it should be left to political elites. Here, Rikki Dean argues that this is old-fashioned thinking. The referendum is not the problem – the campaigns are.
Imagine you are a civil servant. You have just convinced your somewhat skeptical colleagues that your new policy initiative should incorporate extensive public participation in its design process. You now have some tough choices to make: who is going to participate in the process, for example? You know that if you keep participation open to all, then the process will be criticized within your department for just involving the usual suspects. But if you restrict participation, to a randomly selected group for instance, then you know there are some influential policy NGOs who will be vocal about their exclusion…
This post is a response to Sonia Bussu’s recent blog outlining two potential models for the NHS Citizens’ Assembly; the first a deliberative polling approach to informing the overall strategic direction of the NHS; the second, a collaborative problem-solving approach between the Board and citizens.
These are some of my reflections on trying to create a participatory process to involve people in the NHS England’s policy formation called “NHS Citizen”. The thoughts are based on observing an open design meeting held in Bristol on 22-23 October 2013.
The Coalition Government has been at the forefront of using insights from behavioural research to craft more effective policies, ‘nudging’ citizens in other words. Rikki Dean argues that ‘nudges’, especially those that rely on deception or concealment, should be subject to a ‘participatory principle’. Only citizens themselves can legitimately rule on what is in their own interest, and therefore there should be greater exploration around how to involve the public in decisions about their use.