If anyone doubted that politics was always bigger than the political class that has come into disrepute, today is the day. It is the Scottish Referendum, but hundreds of miles further south, I am participating in an other democratic experiment… called NHS Citizen.
NHS Citizen is a work in progress and will eventually be a participation infrastructure for NHS England, where participants can become citizens of the NHS, not just consumers of its services. Through NHS Citizen, the idea is that people are more able to hold the Board to account, set the agenda for discussions, and find others with shared interests – all in an open, transparent and public environment.
The lead design agency is Involve, the recognised national centre of expertise in public participation and open government and a small charity that is led by Simon Burall and of which (to declare my interest) I am trustee and chair. Other agencies are DemSoc, Public-i and the Tavistock Institute.
NHS Citizen will be a system that listens to citizens through both online and offline channels, curating these conversations and exploring evidence.
Today is the first, prototype Assembly, with 250 people brought into an open, facilitated space to talk about priorities for NHS England, with the Board present as equals and able to respond at its AGM later in the day.
NHS Citizen has three layers:
• The Discovery space where information and opinions are gathered through social media, public comment, online and offline tools. This gives a picture of the “state of the conversation” on health, allowing issues of public concern to bubble up.
• The Gather space which will give people opportunities to work together around particular issues, either those that NHS bodies want public opinion on, or those that arise from issues in the Discovery space. These might be issues concerning experiences of patients, users or carers, or those that highlight more general challenges (e.g. how services are commissioned). In this space, a participant “raises a flag,” seeking others who are interested in taking action on that issue.
• The Assembly Meeting will happen twice a year to consider the most important issues in an open and deliberative format, and hold the Board to account. The Assembly Meeting will be able to commission Citizen Panels to consider particularly challenging and controversial issues as part of its way of working.
Democracy is a tool that has far wider reach and potential than we give it credit – in many ways this could be a great age of democracy. It needs to work through across both society and the economy, and at different levels of scale.
The question of how mass membership or public organisations can listen and respond in ways that are open and authentic is a issue on which that the co-operative sector has an enormous amount to offer, but also, with new technology, new expectations, much to learn too.