Book contents
- Frontmatter
- Contents
- List of figures and boxes
- Acknowledgements
- A note on terminology
- Introduction
- Part I Context
- Part II A Citizens Council in action
- Part III Implications
- References
- Appendix 1 Study design and methods
- Appendix 2 Members of the Citizens Council, 2002-05
- Appendix 3 Detailed agenda for the four Citizens Council meetings
- Appendix 4 National Institute for Clinical Excellence: background and developments
- Appendix 5 Key data sources
- Index
seven - Reactions, reflections and reworkings
Published online by Cambridge University Press: 15 January 2022
- Frontmatter
- Contents
- List of figures and boxes
- Acknowledgements
- A note on terminology
- Introduction
- Part I Context
- Part II A Citizens Council in action
- Part III Implications
- References
- Appendix 1 Study design and methods
- Appendix 2 Members of the Citizens Council, 2002-05
- Appendix 3 Detailed agenda for the four Citizens Council meetings
- Appendix 4 National Institute for Clinical Excellence: background and developments
- Appendix 5 Key data sources
- Index
Summary
Public participation is an activity that encompasses much more than the actual meeting period. Each participation project has a history and is followed by social and political repercussions. (Renn et al, 1995: 362)
It is clear that over the first two and a half years of the Citizens Council initiative, the Institute put a great deal of time into shaping just how the Council should work and into modifying its decisions in the light of experience. We have argued that the changes served to create more of an expertise space for citizens and that there was a perceptible rise in the amount of deliberation; we have also shown that important challenges remained. This chapter, the final one in the series presenting empirical data, will explore the thinking that accompanied change within the host organisation. The discursive turn in the study of organisations is particularly helpful here, in its insistence that talk in organisations is not a mere prelude or preliminary to action; instead it much more actively creates and constructs action (Weick, 2004). Chapter Three has already demonstrated how, in setting up the Citizens Council, key players within NICE rehearsed and reframed what were potentially hostile stakeholder constructions of the Institute, placing this latest innovation within their own emerging narratives of the significance of the organisation and its mode of operation. This meaning making continued and intensified as the dynamics of the development of the Council began to unfold. A council fit for citizens had also to be a council fit for purpose within the Institute, and it had to be seen to be so among the different stakeholders to whom NICE related. This chapter traces the discursive work of reframing, and sometimes work of repair, in the face of real and imagined forms of stakeholder interrogation and challenge.
The analysis proceeds via an examination of three particular moments in the overall period under study, each a moment of intense dialogic exchange about the emergent practice that was the Citizens Council. The first section focuses on the aftermath of the first meeting, as the steering committee received the Council's first report and heard the ways in which the facilitators, the project manager and others themselves reconstructed their experiences of the meeting.
- Type
- Chapter
- Information
- Citizens at the CentreDeliberative Participation in Healthcare Decisions, pp. 169 - 190Publisher: Bristol University PressPrint publication year: 2006