Designing Democratic Innovations as Deliberative Systems: The Ambitious Case of NHS Citizen

Abstract

What does it mean to design democratic innovation from a deliberative systems perspective? The demand of the deliberative systems approach that we turn from the single forum towards the broader system has largely been embraced by those interested in designing institutions for citizen participation. Nevertheless, there has been no analysis of the practical implications for democratic innovation. Is it possible to design differentiated but interconnected participatory and deliberative settings? Does this better connect democratic innovations to mass politics? Does it promote greater legitimacy? This article analyses one such attempt to design a systems-oriented democratic innovation: the ambitious NHS Citizen initiative. Our analysis demonstrates, while NHS Citizen pioneered some cutting-edge participatory design, it ultimately failed to resolve (and in some cases exacerbated) well-known obstacles to institutionalisation as well as generating new challenges. To effectively realise democratic renewal and reform, systems-oriented democratic innovation must evolve strategies to meet these challenges.

Testing the input‐process‐output model of public participation

“…While representativeness is the most widely considered normative characteristic, too often critical practical factors are overlooked. The quickest way to undermine a participatory process is to starve it of the resources it needs to function (Baldwin 2020;Dean et al 2019). Thomas and Koontz's (2011; see also Biddle & Koontz 2014) operationalisation of inputs, based on human, financial and technical resources, is a reminder of such overlooked dimensions.…”

Seeing Like a Citizen: How Being a Participant in a Citizens' Assembly Changed Everything I Thought I Knew about Deliberative Minipublics

“…Many academics have acted as neutral observers from the edge of the room or beyond as events unfold and deliberation takes shape (eg. Ryfe 2006;Dean et al 2020). More commonly still, others have taken on the role of action researchers, actively engaging in the process as leaders, co-ordinators or facilitators and reflecting on their experiences and observations (eg.…”

“…But a potentially more transformative idea is that organisers and facilitators might do better to be more open about the limitations from the outset. Most practitioners in this field are acutely aware of the vulnerabilities of citizen deliberation in the policy process (see Dean et al 2020). The point is that this political context is seldom communicated to participants.…”

The Future of Self-Governing, Thriving Democracies

“…For example, mini-publics produce recommendations on the issue/ s at stake, which they transmit to parliaments, city council or other bodies of representation with decision-making power. In recent years, such connections have proliferated throughout the world (Dean et al, 2020;. No existing experiment suffices to realizing self-governing 129…”