five - Better by design? Subsequent Citizens Councils

Summary

Despite the impression sometimes given of the ‘naturalness’ and spontaneous ease of democratic deliberation, artful performances are demanded from citizens, organisers and facilitators alike, if deliberation is to occur, and if its results are to be documented and put to use. Aspects of the design of the Citizens Council meetings changed following the first event, and there were further changes as experience began to accumulate. With different kinds of sessions, a different balance between them and different styles of facilitation in place, the focus of the analysis in this chapter is on the impact of changing design. Using the findings from the ethnographic investigation, we continue to explore the concrete case of the NICE Citizens Council to discover more about the micro-level conditions that impede and facilitate deliberative performances, building up a picture of the kind of community of practice that emerges and the nature of deliberation as a discursive practice.

Data were collected from a further three meetings of the Citizens Council – at Cardiff in May 2003, Sheffield in November 2003 and Brighton in May 2004. By the fourth meeting in Brighton, the Council had been ‘refreshed’. Ten existing members, chosen by drawing lots, had left the Council to be replaced by 10 new members selected following the same recruitment principles. By this means NICE hoped to avoid members of the Council becoming institutionalised, their ordinary commonsense perspectives diluted as they learnt more about health debates. Quantitative outcomes were measured for the second and third meetings in Cardiff and Sheffield using the transcripts of the video records to add to the results from the first meeting. The records from the fourth meeting were included in the qualitative analysis, but time constraints prevented a full quantitative analysis. The research team was requested to give substantial interim feedback to NICE between the second and third Council meetings and this was a further influence on meeting design.

The first section of this chapter reviews the main alterations in the meeting format made by NICE and the facilitators. The second section reports some encouraging results from the quantitative outcome measures for the second and third meetings.