Participation Beyond the Ballot Box

Participation Beyond the Ballot Box

Participation Beyond the Ballot Box European Case Studies in StateCitizen Political Dialogue

edited by Usman Khan University of North London

First published 1999 in the UK and the USA by UCL Press 11 New Fetter Lane London EC4P 4EE The name of University College London (UCL) is a registered trade mark used by UCL Press with the consent of the owner. UCL Press is an imprint of the Taylor & Francis Group This edition published in the Taylor & Francis e-Library, 2005. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” © Usman Khan, 1999 All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Library of Congress Cataloging in Publication Data A catalogue record for this book has been requested ISBN 0-203-98220-7 Master e-book ISBN

ISBN: 1-85728-841-6 HB 1-85728-842-4 PB

For my parents Jennifer and Awais

Contents

Preface

vi

1

European Local Democracy Usman Khan

1

2

Towards a Model of Public Participation Peter McLaverty

23

3

Beyond Nimbyism: Urban Conflict Resolution in Swiss Drug Policies Daniel Kübler

43

4

Deliberation, Democracy and Opinion Polls: Evaluating the Choice Questionnaire Danielle Bütschi

65

5

Planning Cells: The German Experience Peter C.Dienel

81

6

Public Health Panels: Influence at the Margins? Maggie Mort, Stephen Harrison and Therese Dowswell

94

7

Promoting Consumer Choice: Child Day-Care Vouchers in Finland Pekka Kettunen

110

8

Empowering the Parent: User Influence in the Danish Primary School System Eva Sørensen

126

9

Some Concluding Thoughts Usman Khan

142

Notes on Contributors

154

Index

156

Preface

It is somewhat ironic that at the very time that the hegemony of liberal democracy is being heralded by some commentators, a number of the most developed of Western democracies have begun to challenge the veracity of the electoral system upon which it is based. Behind such a challenge lies the observation that voter turnout is falling in many Western democracies and that governments need to be more sensitive to the task of securing ongoing public support for their policies. The result has been the development of an increasing interest within government circles in what maybe termed participation beyond the ballot box. The central focus of this book, then, is public and user participation and the manner in which participative mechanisms have been developed and utilized. The book takes as its central focus the juncture between the state and civil society, where issues of accountability and legitimacy are most commonly addressed. Through the presentation of six case studies, drawn from across northern Europe, the aim is to provide a contextualized overview of current practice. The book has developed out of a workshop on innovations in state-citizen political dialogue, that formed part of the European Consortium for Political Research Joint Sessions held at Oslo University in 1996. The ECPR Joint Sessions provided a unique format in that the ten participants in our workshop were able to focus on a single theme for a period of four days. The book and the workshop have similar aims; they seek to establish a common evaluative framework within which it is possible to consider a series of case studies in public and user involvement. Such an evaluation of the relative strengths and weaknesses of each of the six mechanisms has revealed that it is better to talk about a mosaic of good practice, rather than seeking to highlight the superiority of any one particular method. But having said that, the book does demonstrate a number of trends which are common to all the case studies. Firstly, there is the concern that the public policy process currently lacks legitimacy and that new methods must be developed to address this perceived weakness. Secondly, in devising these new methods, there has been a shift towards those where the potential for reflection, discussion and

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debate has been more apparent, as opposed to reactive forms of engagement, such as offered by traditional opinion polls or referendums. Whether such trends can be said to constitute the development of a coherent pan-European movement is more difficult to establish. Initiatives ranging from citizens’ juries to electronic democracy are being actively considered by a number of northern European governments, most notably by those on the centreleft of the political spectrum. However, it would be fair to say that progress to date has remained piecemeal and that a number of issues will need to be resolved before such participative techniques will be accepted within the mainstream of political decision making. Central among such issues are those relating to power and ownership. Given that a majority of the initiatives discussed in this book have been established by the state rather than the community, doubt remains as to whether the desire to involve both users and public will extend as far as a willingness to transfer to the community a significant degree of power over agenda setting, policy appriasal and policy implementation. In the absence of such a commitment, current developments in public participation will continue to be viewed with scepticism by many of those they seek to involve. However, as this book aims to show, where such a commitment is forthcoming then such innovations can and do offer the potential to significantly strengthen the democratic process. In being charged with the task of putting this book together, my central thanks must go firstly to my editor, Caroline Wintersgill, and UCL Press for their commitment to the project. A big vote of thanks must also go to the chapter writers themselves, who as a team have played a central role in helping to shape and develop the work. Finally, I would particularly like to thank my colleague and friend Peter McLaverty for his ideas and support and my wife, Nathalie, who provided much needed support through the writing and editing process.

CHAPTER ONE European Local Democracy Usman Khan

Introduction The desire to increase the involvement of citizens and users in the management and organization of public services has been a recurring theme within current debates on municipal governance (Gyford 1991; Stoker 1991). In some ways citizen and user involvement may be said to encapsulate the defining difference between current ideas of local governance and traditional views of local government. Within such debate the term “government” is often associated with paternalistic political structures and a single service provider, whereas governance suggests a greater community involvement in the policy-making process coupled to a greater range of user-oriented service providers. Yet while great play is made of the potential that public participation initiatives such as citizens’ juries, user boards or community forums can play in helping to establish this order of governance, evaluation of the impact of these new mechanisms has only recently begun. The aim of this book is to provide some help in this process. The case studies for the book are drawn from five northern European countries. While I would not seek to present them as offering a complete geographical or structural overview of current developments in public participation—that task is beyond the scope of a single volume—we do feel they represent current practice. In doing so, the reader has the opportunity to assess each innovative method in its own right, as well as to consider them within a common contextual framework. As such we feel this book will be of value to students, researchers and public policy practitioners. This first chapter has four substantive elements. The first seeks to establish the structural, geographical and historical factors which differentiate the countries of northern Europe. The second focuses on three enduring themes of the last decades of the twentieth century: fiscal crisis, public disenchantment with local and national government, and the development of the European Union. Together they have provided much of the impetus for European public policy reform. This will lead on to a discussion of the role played by public participation within this reform movement. The final section summarizes the rest of the book.

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Government, Politics and the Locality in Northern Europe One question that a volume such as this must seek to address is to what extent the case studies presented offer a meaningful basis for cross-national comparison. How do we weigh the extent to which each country operates within a set of unique political, economic and social conditions, against those factors which act to create a common public policy agenda? Can the evaluation of health panels in Britain, planning cells in Germany or nursery vouchers in Finland present generalizable findings, or is it the case that each individual initiative is situationally constrained to an extent that it can offer little if anything that would be applicable outside its immediate situation? I contend that there are generalizable findings, and in the following sections I will seek to establish how the countries of northern Europe have increasingly become subject to a common set of pressures and priorities within the field of public policy. Northern Europe: A Common Starting Point There is an absence of agreement among writers concerning how best to categorize the liberal democracies of western Europe (Norton 1991; Goldsmith 1996). Some, such as Hesse and Sharpe, focus on constitutional arrangements and have divided Europe into Anglo, Franco, and north/mid European groups. Page and Goldsmith (1987) use similar criteria to argue for a twofold division into northern and southern Europe. By comparison, Goldsmith (1996) focuses on cultural as well as administrative structures to distinguish a northwest European group of countries. He argues that: What sets these countries apart is a general belief in the values of local selfgovernment and decentralisation. (Goldsmith 1996:186) This classification fits in with that of Norton (1991), who puts forward a threefold grouping of Britain, northern Europe and southern Europe. The case studies for this book are drawn from Britain, Denmark, Finland, Germany and Switzerland. With Britain standing alone, the remaining countries all come within both Norton’s and Goldsmith’s northern European group. However, when considering political tradition and structure alongside the impact of globalizing forces such as new public management and the European Union, I contend it is more appropriate to consider an extended northern European triangle of countries with Finland, Britain and Switzerland at each corner. Constitutions, Structures and Political Tradition Of the five countries studied, two are what may be termed fully federal systems; they are Germany and Switzerland. Switzerland has been described as a weak state; this is because history has determined that, since its inception, powers have

EUROPEAN LOCAL DEMOCRACY 3

been transferred from the locality to the centre rather than the other way around (Badie and Dirnbaum 1979). Consequently, while there is no formal power of general competence for the 26 cantons or the municipalities and communes below them, Strehl and Hugl (1996) feel able to argue that: Federalism, local implementation and subsidiarity are the main principles that characterise the politico-administrative system of Switzerland. (Strehl and Hugl 1996:222) The administrative system in Switzerland is underpinned by a combination of representative and direct forms of democratic practice which seek to ensure that the local, regional and national tiers of government operate in a broadly consensual manner (Badie and Dirnbaum 1979). For writers such as Kriesi (1995) it is direct democracy, in the form of public referendums, that is the single most important feature of this process. Grunow (1991) argues that governmental structures in Germany are largely the product of a post-war settlement which sought to build into the new German constitution checks against centralized power. The administration of local government in Germany, which is based around the concept of the Rechtsstaat (judicial state), has been said to most closely resemble the classic Weberian bureaucracy (Klages and Loffler 1996). There are three levels of government: Bund, Länder and Kreise/Gemeinden, with local self-government constitutionally guaranteed. Local autonomy has been further strengthened by the growing influence of Bürgermeisters (mayors) and Grunow goes as far as this: It has become quite clear that most of the legitimisation for the political administrative system has to be secured by local politics and administration. (Grunow 1991:76) In recent decades this local political scene has undergone significant change, as forms of direct democracy have been introduced to stand alongside existing representative structures. In Bavarian southern Germany, developments have often drawn upon the Swiss tradition of referendums, while innovations in the north such as the Planungszelle (planning cell) have been used by a number of local and regional authorities. Finland and Denmark both form part of the Scandinavian tradition of vibrant and autonomous local government. The two-tier Danish system of government which is underpinned by a power of general competence is highly decentralized in nature (Norton 1991). This process of decentralization began in the 1970s when central government began to devolve responsibility for services to local authorities. It was then developed further as local government began to devolve responsibilities to local institutions through the use of user boards. Democratic involvement in Denmark has primarily been centred on traditional representative structures, although since their introduction in the early 1980s, the use of user

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boards has created more interest in the development and utilization of innovative forms of democratic involvement. Government in Finland is similar to that in neighbouring Scandinavian countries, in that responsibilities for a broad range of local services have been decentralized to the local level. Local authorities and “municipal federations” are responsible for education, health, social services, leisure and a range of technical services. Yet in a number of ways Finland stands apart from its immediate neighbours. Firstly, the Finnish state is more centralized, in that local authorities are viewed primarily as being the implementers of central government policies. Secondly, while local government in Finland does enjoy a degree of local autonomy with respect to issues relating to service delivery, this has not led to the introduction of mechanisms aimed at greater citizen or user involvement. Finally, Finland’s strong trading links with the former Soviet Union, combined with powerful rural-agrarian interests have until recent years, acted as a counterbalance to the western European public policy reform movement (Pollitt et al. 1997). Britain’s system of local government stands in stark contrast to those of continental northern Europe. Firstly, a combination of a highly centralized unitary structure of government coupled with an electoral system which favours single-party majority government, and the lack of a defined constitutional position for local government, has allowed central government to exercise a degree of control over local government which would be unheard of in the rest of western Europe. British local government operates on the largest scale of any western European country. The average size of the basic authority in Britain in population terms is 127,000. This can be compared to 7,200 in Germany, 10,600 in Finland, and 17,900 in the Netherlands (Norton 1991). Britain also lacks any meaningful form of meso-level government, and has the lowest levels of voter participation in local government of any of the northern European countries. Despite this, during the 1980s a number of socialist-controlled local authorities did attempt to create an independent and distinct role for themselves (Gyford 1991; Stoker 1991; Burns et al. 1994; McLaverty 1996). Yet developments were often short-lived, undermined or outlawed by a hostile Conservative central government. This led Gerry Stoker to argue that by the late 1980s and early 1990s: It has to be conceded that the sense of crisis, uncertainty and loss of legitimacy is greater in British local government than is the case elsewhere in Europe. (Stoker 1991:12) Whether this remains the case is less certain. With the election in 1997 of a Labour government committed to reintroducing a degree of local autonomy for local government, there is some evidence of Britain seeking to bring itself into line with mainstream European views of local government and democracy.

EUROPEAN LOCAL DEMOCRACY 5

A Culture of Local Government A picture begins to develop of highly differentiated systems of local government across northern Europe. Yet the factors which underpin the operation of local democracy often add up to more than can be offered by a structural evaluation alone. Thus Norton felt able to comment that despite structural differences: It is remarkable how deeply local government values are rooted in continental Europe compared with the situation in Britain. (Norton 1991: 38). In the next section of this chapter we see how northern European countries have been subject to common economic and political forces which have acted upon them to reinforce such a common agenda, with respect to public service provision and the frameworks for citizen and user involvement which surround it. In doing so, we will also consider whether it still holds true that Britain stands apart from the rest of northern Europe with respect to local democratic practice. From Economic Crisis to Political Union: A Common European Framework? Three issues have combined to generate a common political and economic agenda for public sector reform within western Europe. Firstly, the 1973 oil crisis and resultant period of stagflation among most western nations caused a fiscal crisis of the state (O’Connor 1973), which in turn has led to a fundamental reassessment of the role and extent of the public sector. Secondly, many Western nations have at the same time witnessed a decline in voting levels, which has led a number of them to re-evaluate the manner in which liberal democracy works at the local level. Finally, for all the northern European countries addressed in this book, with the exception of Switzerland, the European Union as a political entity has also been of growing importance. These three factors have combined to provide the momentum for the public policy reforms that have been witnessed over the last three decades. However, and as we shall see, this momentum conceals differences in relation to the evaluation of past problems and the solutions put forward to resolve them. While neoliberals, supported by the writings of academics such as Niskanen (1971) and Hayek (1976), came forward to advocate market-based reforms, those on the Left such as Clarke and Stewart (1986) offered an approach based on the citizen. Fiscal Crisis and Western Capitalism Most western European nations experienced substantial economic growth during the post-war period. In the advanced capitalist countries, output levels grew

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annually by an average of 4.9 per cent for the period 1950–73, compared with 1. 9 per cent in the period 1913–50 (Harvey 1990). The public sector grew by similar levels, expanding its scope into health, housing and social services, and expanding its revenue commitment particularly in terms of transfer payments. The 1973 oil crisis, coupled as it was with high inflation levels, brought the postwar boom to a sudden halt. In the period 1973–9 annual average growth rates among Western nations fell by almost one-half to around 2.6 per cent (Harvey 1990). The effect on the public sector was neither immediate nor uniform, yet there is little doubt that 1973 represented a watershed for governments’ views of the public sector, with a broad acceptance that the scope, scale and related expenditure levels of the public sector needed to be reined back, while the management and organization of the public sector needed to be better structured and more responsive. As the then British Labour Minister, Anthony Crosland, told a local government gathering, “The party’s over” (Hampton 1987). Public policy reform since this time has taken on a cyclical appearance, with one reform movement often following on directly from another. While some have had a greater ideological underpinning to them than others, all have shared a common agenda, which has been to reduce the cost of public service provision through greater efficiency savings while at the same time seeking to make services more responsive to those that use them. These issues are returned to later in the chapter. Voter Apathy: Representative Democracy under Threat? One starting point for establishing the relative vibrancy of local democracy tends to be evidence of voter interest in the institutions of the state at a national level and more importantly at a local level. Britain has one of the lowest levels of voter turnout in northern Europe, with figures ranging from approximately 70 per cent for national parliamentary elections to under 40 per cent for some local council elections (Gyford et al. 1989). By comparison, turnouts on the continent, particularly in Scandinavia, have historically been high. However, a fall in local election turnout in Denmark from 72.3 per cent in 1981 to 67.6 per cent in 1989 caused a good deal of disquiet among local and national political elites, and a similar trend has been identified in Norway (Villadsen 1993). Of equal interest is the fact that despite, or possibly due to, the significant number of points at which Swiss citizens can exercise their democratic rights, turnout levels for both representative and direct forms of democratic involvement are often well below 50 per cent (Kriesi 1995). Whether or not voter turnout truly reflects the level of public commitment to the representative democratic structures or local service provision is not an easy issue to resolve. Thus many English-speaking countries, including Britain, the United States and Canada have historically had relatively low turnouts. The issue is further clouded by the fact that in Britain, in particular, low electoral turnout does not appear to affect public satisfaction levels with local government. While

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a survey for the Widdicombe Report revealed 32 per cent to be satisfied with the government’s running of the country, an average of 53 per cent declared themselves to be satisfied with their local council (Gyford et al. 1989). But despite these ambiguities, the political elites of many western European countries have felt the need to respond to any fall in electoral turnouts, in particular by attempting to develop citizen and user involvement in the policy process. The Impact of the Economic Union With the exception of Switzerland, the countries examined in this book are all member states and as such they have been subject to the increasing influence of the European Union (EU), a central element of which has focused on policy making at the local level. The Charter for Local Government established in 1981 and subscribed to by all member states underpins the EU’s commitment to local government. Clarke and Stewart have argued that the charter is cautiously framed, but in its principles it gives a status and a protection to local government which is lacking in Britain. (Clarke and Stewart 1991: 35) In addition the Committee of the Regions, which seeks to place local communities at the heart of EU policy-making, has been enthusiastically built upon by meso levels of government such as the Länder in Germany. Finally, and potentially of the greatest consequence, is the concept of subsidiarity. The preamble to the Maastricht treaty asserts that member states should ensure that “decisions are taken as closely as possible to the citizen in accordance with the principle of subsidiarity” (Bogdanor 1992). Article 3b of the treaty, added during a British presidency, has attempted to refocus the principle of subsidiarity towards a decentralization of power from EU institutions to national governments; nevertheless, Maastrict has given significant impetus to the democratization movement. Cram and Richardson (1992) argue that enhanced rights for local government and European citizenship are at present more rhetoric than reality. Yet the potential for further devolution of powers beyond national governments remains, and evidence of this can be found in the increasing requirement for local authorities to seek local community involvement for all important EU regional funding (Bogdanor 1992). Reaction and Renewal: The Development of the Enabling State There were several responses to the financial and political problems faced by European governments in the 1970s; the most significant of which was called new public management (Pollitt 1990). Underpinned by the work of liberal

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economists such as Hayek (1944) and Friedman (1962) and public choice theorists such as Niskanen (1971), new public management has been translated into popular orthodoxy through books such as Osborne and Gaebler’s (1992) Reinventing Government. Operating at both a political level and a managerial level, new public management spoke of the need for the public sector to rid itself of the yoke of paternalism. The public sector should “steer and not row”, it should be concerned with setting broad objectives rather than necessarily delivering services. At the heart of this new public management agenda lay a neoliberal critique of the public sector, which envisaged a much reduced role for it in the future (Flynn 1993). As Philip Blair states, new managerialism was seeking “to make the public sector retreat from what they see as its exaggerated aspirations to regulate society and care for its needs” (1991:48). The new public management reforms of the 1980s and 1990s have manifested themselves in a number of distinct ways in different countries at different times. In summary they have been concerned with a fundamental reassessment of what should and what should not to be funded by the state, what should and should not to be provided by the state, and finally what is the most efficient and effective way to provide public services. Democracy and public accountability have been addressed as part of this, but cannot be considered to be the primary motivating force behind these changes. Financial Austerity and Central Local Relations The central determining force behind new public management reform has been the need to reduce public expenditure. This assertion finds material support in a study by Flynn and Strehl (1996), which found a direct relationship between the share of GDP taken by the public sector and the pressure on the public sector to adopt new public management reforms. And given that in many western European countries, local government accounts for around one-half of all public spending, it is hardly surprising that since the mid-1970s a number of attempts have been made to reduce spending on local services, often with a centralizing effect on public policy-making. Local government in Britain lacks the substantive role ascribed in law that is the case in most other northern European countries. This has meant that while a significant proportion of taxes are collected locally, successive governments since the mid-1970s have passed legislation which has severely curtailed local financial autonomy (Stoker 1991). Capping legislation in particular, which has given central government the power to impose financial penalties on any local authority that exceeds centrally determined budget limits, has succeeded in giving central government ultimate control over resource allocation. For over a decade local authorities have found means to circumvent the legislation; however, central government has now closed most, if not all, the loopholes (Elcock et al. 1989).

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Although the highly confrontational style of central-local relations that developed in Britain has not been evident to anything like the same extent in other northern European countries, the desire to exercise a greater degree of central government control over local government spending has been a reccurring theme. Sweden has a system of local income tax that gives local authorities a high degree of local autonomy. Tax levels were frozen by a Conservative-Liberal coalition government in the period 1991–4 (Wilks 1996). Denmark has experienced similar trends, and local authorities in the Netherlands are almost wholly reliant on central government grants, which have been cut in recent years (Flynn and Strehl 1996). In Finland, currency instability and the loss of the Soviet market after 1991 have brought about significant pressures to reduce public spending and to improve the efficiency of the public sector (Pollitt et al. 1997). Switzerland’s buoyant economy along with its relatively small welfare state and flexible system of “guest workers”, insulated the state from global economic pressures during the 1970s and 1980s, but pressure is now growing for institutional reform of the public sector (Hug and Sciarini 1996). The Enabling Authority The belief that government need not itself be a direct service provider has been evident in a number of northern European countries for a number years (Clarke and Stewart 1991). This idea of an enabling authority, like so much of the new public management reform movement, is based upon the critique of public choice theorists such as Niskanen (1971). Yet when seeking to develop such enabling authorities, governments have also drawn upon competing discourses such as Clarke and Stewart’s (1986) public service orientation. The result has often been contradictory sets of policies. In both cases these policies have seen a reduction in the importance of the state at the local level through the transfer of responsibility for public service provision to the private and voluntary sectors. For proponents of the orthodox neoliberal school of thought, this has coincided with a reduction of state involvement at the local level. But for others, the freeing up of the state from the responsibility for directly providing services has in fact opened up the possibility of taking a more strategic, but no less substantive, role in the local policy process. Nowhere have these contradictions been so apparent as in the European decentralization programmes of the 1980s and 1990s. Decentralization For countries in northern Europe the process of decentralization has been one of the most important aspects of the public sector reform movement of the last two decades. Following the pattern which has seen a reduction in the number and an increase in the size of local authorities throughout Europe (Norton 1987), the decentralization process has sought to redress the balance by devolving

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responsibility for a greater number of public services to lower tiers of government. Decentralization has been an important factor in new management reforms in Scandinavia, most notably with the “free commune” experiments (Baldersheim and Ståhlberg 1991). The aim of such free communes has been to increase local adaptability, lessen state control and increase local influence in local policymaking (Blair 1991). The free commune experiment has also been adopted in a modified form in Germany, where local authorities have come together in “innovation circles” to share good practice. A second aspect of decentralization in continental Europe has been the role played by nongovernmental organisations (NGOs) and extra-governmental organisations (EGOs). In Switzerland, NGOs now play such an important part in local service provision that Bütschi and Cattacin (1994) argue that this new era of what they term “reflective subsidiarity” constitutes a significant revision to the traditional Swiss political system. Two distinct and in part contradictory decentralizing trends can be identified in relation to the British case. On the one hand a series of policies enacted by successive Conservative governments since 1979 have sought to decentralize aspects of the local management of public services, while retaining political control over them. In areas such as education, employment training and health, this process of decentralization has seen the establishment of a series of quangos (quasi-autonomous non-governmental organizations). These quangos are typically accountable to a board of nominated local representatives appointed by central government. One estimate suggests that quangos now account for over a third of public expenditure at the local level in Britain (Weir and Hall 1994). What sets this British model apart from the rest of northern Europe is principally the issue of local accountability. Britain has seen a substantial transfer of responsibility for the provision of local services to over 7,000 extra-governmental organizations, many of which would traditionally be provided by local government, and where the principal line of accountability lies with Parliament rather than local government and the local community. The second trend has operated at the local level and can in a number of ways be likened to the free commune movement on the continent, where several local authorities, operating without central government support, took it upon themselves to develop innovative ways to decentralize services within their respective localities (Burns et al. 1994). However, the policy lacked central government support, and in the face of continuing financial austerity, little substantive progress has been made. Decentralization represents an organizational response which has within it elements of both the neo-liberal and social democratic critiques of government and public policy. The examples cited above relate in the main to the social democratic traditions. Those outlined below focus on decentralization as a means of transferring responsibility for the delivery of services from the public sector to private providers.

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Privatization and Contracting Out One of the most significant aspects of new public managerialism has been the privatization or contracting out of public services. This process has taken three distinct forms. There has been the wholesale privatization of industries such as coal and steel, utilities such as water, gas and electricity, and single companies in areas such as computing, telecommunications and transport; there has also been the contracting out of individual service areas such as refuse collection, leisure management and social care. Of these, contracting out has had the greatest impact on local government and local democracy. Privatization on the continent has been much more pragmatic. Sometimes it happened because service areas were developing so fast or required such large levels of capital investment that the private route was the only feasible one. And sometimes it happened because people believed a private or voluntary sector operator could provide a more responsive, flexible or cheaper service. Although such imperatives were also evident in Britain, privatization was also very consciously put forward as a New Right rejection of the public sector and its attendant social democratic consensus (Asher 1987). Germany has seen the contracting out of cleaning, slaughterhouses and refuse collection. However, this has mostly involved NGOs rather than the private sector, so it cannot be viewed as constituting the full-scale marketization of municipal services (Grunow 1991). In Denmark too, marketoriented decentralization of local services has been evident, most notably after a Centre Right coalition took control of central government. They have introduced a modest programme of privatization, most notably in the form of a limited purchaser-provider split in local health care provision. Again the central characteristics of this change have centred around decentralization, privatization, and the greater use of contracting. Yet, in assessing the impact of this change on Denmark, Villadsen argues that developments have not progressed as far as in countries such as Britain: Popular support for local government service provision combined with its high efficiency has made massive privatisation programmes difficult in a Danish context. (Villadsen 1993:53) The same can be said for both Finland and Switzerland, where again privatization is only now beginning to become a reform strategy. In Switzerland the state-run telecommunications industry has been privatized so it can compete in an increasingly global market, whereas other utilities such as electricity have been liberalized. At a local level, a number of authorities have taken some steps towards privatization, most notably city authorities with Centre Right coali tions, e.g. Geneva, but in most cases NGOs have been the focus of this service reorientation. Telecommunications have been privatized in Finland; and at local

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level, the Finnish voluntary sector and NGOs have been encouraged to become public service providers. In Britain the process of privatization and contracting out has been more widespread and more profoundly ideological in intent than in any other northern European country. With one or two minor exceptions, all British utilities, industries such as coal and steel, along with the public transport infrastructure, have been privatized since 1979. In relation to contracting out, central government has passed legislation to ensure that manual services such as cleaning and rubbish collection and latterly services such as financial management have had to be market-tested. This is not to say that ideology has played no role in the privatization programmes of northwestern European countries other than Britain. Even in Sweden, the bastion of Scandinavian social democracy, one can cite the example of Stockholm County Council: under a rightwing leadership in the early 1990s, it went as far as introducing a scheme to privatize the city’s major hospital (Flynn and Strehl 1996). Consequently, when taken as a whole, the privatization programmes introduced across Europe can be seen in part to reflect a realignment of the scope and scale of the public sector, and in part an attempt to drive down costs and improve levels of efficiency. Models of Change Since the early 1980s, Britain has been at the forefront of developments in new public managerialism. It has privatized a greater number of services, introduced contracting out into more areas and developed the client-contractor divide to a greater extent than any other single country in the northern European group. The momentum for such change has come almost exclusively from the Conservative governments of Margaret Thatcher and then John Major, operating particularly in the 1980s, in the face of not insignificant opposition. Change has also gone beyond the provision of services and the introduction of the client-contractor split, to the internal management of local authorities. Thus, for countries such as Switzerland, where there has been increasing criticism of public service provision, focus has been on the internal management of the public sector with programmes such as the new “controlling systems” (Strehl and Hugl 1996). Switzerland has probably been the most reticent of all the northern European nations with respect to new public management changes. A number of reasons can be put forward for this. Firstly, Switzerland has not faced financial difficulties to the same extent as other European countries. During the 1970s, Switzerland was the only OECD country to match public sector expenditure increases by revenue increases, therefore not having to rely on increased public borrowing. Secondly, the decentralized political system far predates any changes brought about by new public management. Thirdly, there is already a high level of citizen involvement in local policy-making as a consequence of the Swiss commitment to direct democracy. Finally. the bureaucratic system follows the

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more traditional Weberian model, which mitigates against radical marketoriented change. However, with increased financial pressures in the 1990s, new public management has now become very popular in Switzerland, particularly at the local level (Hablåtzel and Haldermann 1995). A number of these reforms have focused on service delivery issues, although most have focused on budgeting and strategic management (Strehl and Hugl 1996). In Germany too, reform has been slower and more cautious, being focused primarily on the Länder and Kreise/Gemeiden. Borrowing primarily from “good practice” in the Netherlands, the local authorities consulting agency (KGST) devised a new steering model (NSM) which set standards for budgeting, total quality management, performance indicators, outsourcing, competition and customer orientation. Sharing some similarities with the free commune experiments in Scandinavia, around one-third of all authorities have adopted some form of NSM programme (Klages and Loffler 1996). Villadsen (1993) argues that developments in Denmark have taken four main routes. Firstly, this has involved radical decentralization from state to municipality, the central aim being to build out the influence of large numbers of pressure groups felt to have driven up costs. The second aspect has been to reduce political regulation, be that through a reduction in council committees or a reduction in the influence of complaints boards. The third aspect has been an increase in direct charges for local services. Finally, alongside other Scandinavian countries, Denmark has embarked on a programme of municipal deregulation. This reform movement was initially led by a right-wing coalition which came to power in 1982. What is interesting and what has been repeated across northern Europe is that while the Centre Right were often the first to lead the new public management reform movement, this lead has been carried on in only a slightly modified form by Centre Left governments that have succeeded them. The Finnish case offers a slightly more confused picture. Before the early 1990s, Finland could be said to have been in the slipstream of the broader European public sector reform movement. The financial imperatives brought about principally by the break-up of the Soviet Union, mentioned earlier in this chapter, have led the Finns to adopt a broader range of new public management reforms. There are examples of reform in most areas of public service, including the commercialization of public railways and postal services, the privatization of the telecommunications industry, and the contracting out of local services, although on the whole the process has been slower and subject to more resistance at the local level than in many other countries examined in this book (Klausen and Ståhlberg 1997:3). Consequently, while new public managerialism may have been more overtly ideological in Britain and its pace greater, the overall pattern for local service provision has certain similarities across northern Europe. These similarities have become all the greater in the light of the election of a Labour government in 1997, which has seen Britain coming into line with the rest of northern Europe with

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respect to a number of important policy areas. These include meso government, elected political executives at the local level, the enabling council with a greater reliance for service delivery on arm’s-length non-governmental organizations, a coalescing to a common agenda of the main political parties, a reorientation towards service users, and a greater commitment to involve the local community in aspects of the policy-making process. Given such similarities of approach, what is important for the evaluation of the cases studies presented in this book is to deconstruct the pressures to reduce the scope and scale of the public sector, from the desire to involve the public as citizen and service user in the planning and management of their local services. This will be the focus of the next section. Public Policy Reform and Local Accountability In some ways it may appear strange to have started a book on local democracy with a review of public policy reform. Yet it would be difficult to overstate the impact that new public managerialism has had on developments in public participation. As has been demonstrated, much of the reform movement has been at least in part a response to the perceived paternalism of existing public services, and this response has taken two distinct routes based around the public as citizens and consumers (Gyford 1991). Consumers and Citizens New public management in Britain has been accompanied by a fundamental reorientation of local accountability away from the citizen and towards the consumer. The rationale for this was laid out by William Waldergrave, then a senior member in John Major’s government, when he argued that the “key point” is not whether those who run our public services are elected, but whether they are producer-responsive or consumer-responsive. Services are not necessarily made to respond to the public by giving our citizens a democratic voice, and a distant and diffuse one at that, in their make-up. They can be made responsive by giving the public choices, or by instituting mechanisms which build in publiclyapproved standards and redress when they are not attained. (Weir and Hall 1994:12) This sentiment underpinned much of the Conservative governments’ new public management reform agenda after 1979. Where possible, public services were placed within the realm of the market, be it through privatization or contracting out. Where the service remained a monopoly, or contracting out did not proved feasible, then mechanisms such as “charters” were introduced which sought to strengthen people’s rights as service users. The Patients Charter in the National Health Service laid out a series of targets such as a maximum waiting time for

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outpatient appointments. Alongside this, comment and complaints systems were introduced and public sector organizations were encouraged to seek the views and opinions of services users through surveys, focus groups and other similar market research techniques. These were initially developed in the 1990s by New Right authorities such as Brent, Wandsworth and Westminster, but have since become commonplace across the public sector in Britain. Consumer-oriented reforms have also been introduced in other northern European countries. Passau and Duisburg are just two examples of German cities which have focused on the service user through the greater use of opinion surveys and other market research techniques (Grunow 1991). In fact, in all the countries of northern Europe, the position of the service user has been strengthened both through the adoption of market research oriented voice strategies as well as through the provision of exit strategies such as that offered by vouchers. Yet overall, two things remain apparent when comparing the British experience to the countries of northern Europe. Firstly, consumer-oriented reforms have not been as prevalent as in Britain; and secondly, new public management reforms have not produced any meaningful denigration of the role of the citizen in the policy-making process. Returning to the example of Germany, Grunow argues that “the strengthening of the role of the consumer visà-vis public services does not enjoy a high priority” (1991:40). The German emphasis has been on making improvements to what they consider high quality services with better training, more flexible service delivery and better service environments. When examining the role of the citizen in relation to current reforms, one is again struck by the apparent differences between the British approach and the approach of other northern European countries. Gerry Stoker argues that on the continent “overwhelmingly the impression is of a degree of relative satisfaction with the question of local political control and democracy” (1991:11). Philip Blair takes this a step further, arguing that, if anything, there is concern that the role played by the citizen in the policy-making process should be developed further: There are clear signs of concern with reinforcing the (direct or indirect) democratic mechanisms for the collective government of the community. (Blair 1991:50) Blair argues that in Sweden “the emphasis is not so much on restricting the scope of local government as on improving the functioning of local democracy” (1991: 48). In Denmark, while user-led democracy has been a significant focus of reform, local democracy has not been subject to any fundamental criticism (Cram and Richardson 1992). But having said that, Switzerland stands somewhat in contrast to the other countries in the northern European group. There has in fact been some debate as to whether Switzerland’s extensive framework for the direct democratic involvement of its citizens does not in fact have its drawbacks.

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Writers such as Papadopoulos (1995) now talk about direct democracy introducing a “dose of uncertainty” into the policy process. It has even been suggested that the threshold for the popular referendum should be increased in order to discourage its use, although this has met with strong public resistance (Longchamp and Hardmeier 1991). In Britain the hostility of central government to the workings of local democracy has been the guiding principle behind the attempt to undermine the position of local councils through the establishment of a plethora of quangos whose principal accountability to the community is via Parliament. Without many of the checks and balances evident in many of the continental liberal democracies, the Conservative governments of Margaret Thatcher and John Major were able to impose a consumerist model at the expense of local democracy. For other northern European democracies, stronger social democratic traditions, coupled to political systems based upon coalition government and a greater separation of powers between the centre, region and locality, have meant that market-oriented reforms have not been established with the same vigour or to the same extent as in Britain. And since the election of a centre-left Labour government in 1997 there have been signs that Britain is also beginning to take a more pragmatic approach to public policy reform, alongside a greater commitment to strengthening representative democratic structures at the local level. For those supporting market-oriented reforms, involvement at the local level is focused primarily on the service user as customer. The alternative has been to focus on the service user as citizen. Developments have ranged from the introduction of area-wide neighbourhood councils to the use of citizens’ juries for considering single issues. Most of these initiatives were initially developed on a piecemeal basis at the local level, with little if any direct involvement by central government or international agencies such as the EU. The significant exception to this is Local Agenda 21, where for the five-year period up to June 1997, international, national and local organizations have worked together to help initiate consultative processes within their communities, so as to develop more holistic and long-term programmes for realizing the agenda at the local level (Lafferty and Eckerberg 1997). However, what the accounts given in this book do show, is that mechanisms targeted at the citizen rather than the consumer have become the focus for significant attention in recent years. This has been witnessed both in countries with weaker local democratic structures such as Britain as well as those with more developed systems such as Switzerland. For the British Labour govern ment of Tony Blair, citizens’ juries, referendums, and public panels are being actively considered as mechanisms which can help revitalize local democracy. Countries such as Switzerland are considering participative mechanisms which rely on a greater degree of reflection and debate than has been evident in the system of national and local referendums.

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Complementary Forms of Participation Current developments in public participation have been a response to both economic and political concerns. The result has been a range of initiatives which draw upon one tradition or sometimes both traditions. On the one hand, a number of reforms have been associated with new public managerialism and the desire to increase the role of the service user as customer, through the provision of mechanisms for what Hirschman (1970) has termed “voice” combined with those he terms “exit”. The principle behind this strategy has been to marketize public services and in doing so provide service users with greater responsiveness underpinned by greater choice. The counter to this has involved initiatives which have focused entirely on promoting voice, hence highlighting the importance of deliberation and collective decision making. The evaluation of these new systems and structures for public involvement is a developing field of study (Gyford 1991; Burns et al. 1994). As such, there is no properly agreed definition of what constitutes public participation. In order to help address this shortfall, I have developed the idea of complementary forms of participation. By a complementary form of participation (CFP) I mean systems or structures which have been established by state agencies, operate at the juncture of the state and civil society, and seek to augment rather than replace or compete with existing representative governmental structures. CFPs can be viewed as bodies which seek to act as a communicative bridge between the state and civil society. As will become apparent not all the case studies considered in this book fit comfortably within our definition. However, it does provide a common reference for the remainder of the book. Conclusions Flynn and Strehl (1996) argue that public sector reform has not produced a uniform response across northern Europe. Others such as Ridley (1996) or James and Manning (1996) do feel that, at the very least, there has been a process of lesson drawing within western Europe and beyond. Although the OECD/PUMA group believe there has been some evidence of convergence in respect of management and organizational issues, Flynn and Strehl have reason to challenge this. They argue that while there may be examples of common practice with respect to privatization or contracting out, convergence may have more to do with rhetoric than reality. They identify three variables that have influenced both the speed and degree of reform within the public sector in Europe. These are constitutional arrangements, the degree to which there is a strong ideology supporting reform, and the cultural attitudes towards the role and nature of the state. Having considered political culture alongside constitutional structures, the next section goes on to examine the importance of ideology in the public policy reform movement along with its relationship to the development of public participation strategies.

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Ideology and Reform A picture begins to emerge of a group of countries which have been subject to a similar set of economic pressures and whose governments have responded to these pressures with a thorough re-evaluation of both the extent and the operation of the public sector in each of their respective countries. For countries such as Britain, this has been built upon a firm ideological base of neo-liberalism. For other northern European countries, this ideological underpinning has been less apparent. In Germany, for instance, political tradition combined with a decentralized and federalized system of government has meant that change has been more cautious (Klages and Loffler 1996). Such caution was reflected in the fact that during the 1980s, when new management reforms were at their height in Britain, Germany actually introduced a reform moratorium. But it would be incorrect to assert that ideology has played no role in the public sector reform movement in the countries of northern Europe. Villadsen (1993) argues that in Denmark the Right has had some success in seeking to take control of the political agenda because it has been more certain about how it intends to handle public management reforms, whereas the Left has had little more to hang onto than decentralization. Løchen goes as far as to argue that: Today the welfare state has no banner…except social democratic pragmatism (which) does not excite people. (Villadsen 1993:123) However, Villadsen argues that popular support for local government service provision combined with its high levels of efficiency has stopped the Right from being able to fundamentally challenge the social democratic political tradition in Scandinavia. A middle course has been followed, although he warns that: The strength of the local democratic model lies in the complexity of democratic forms, the protection of social and political citizenshipand the perspective for further local democratic development. (Villadsen 1993:54) Villadsen’s point is an important one because it makes the link between ideology, public policy reform and local democracy. This link is central to evaluating new methods of public involvement—the subject of this book. A Common Agenda? To what extent have the developments within this book taken place within the context of a common agenda? It is apparent that the traditions and structures which are particular to each country have had a significant bearing on how they have responded to the globalizing effects of the 1973 oil crisis and similar events, especially how they have sought to address issues of public accountability and legitimacy. And it is apparent that ideology has also played an important part in

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determining both the pace and manner in which each country has addressed the issue of reform. Approaching the turn of the millennium, we are beginning to see countries from Sweden to Spain adopting participative innovations such as citizens’ juries, and they are increasingly being viewed as part of what Anthony Giddens, among others, has termed the “third way” for public policy reform (Giddens 1998). Outline of the Book In the next chapter, Peter McLaverty outlines the main theoretical debates surrounding the subject of public participation. Using traditional analytical tools such as Arnstein’s ladder and Hirschman’s conception of voice and exit, he then seeks to place ideas of participation within current debates on the role of the citizen in modern Western democracies. In the final section of his chapter, he outlines an additional evaluative tool, the public involvement model, which came out of the ECPR workshop that led to this book. There are two case studies from Switzerland. Daniel Kubler examines one way in which local drug agencies in Switzerland have tried to come to terms with the need to develop and maintain harm reduction facilities (HRFs) for drug users, through the greater involvement of the local community. As a consequence of the significant levels of local autonomy and citizen involvement in local policymaking, the Swiss case study offers a unique insight into the workings of public participation initiatives within a highly developed political system. In this case, local communities initially constructed a traditional nimby (not in my backyard) response to the introduction of the HRFs. However, the impasse that this created then forced both the community and the authorities in Basel to reassess their respective positions. The result was unique, not simply because it led to a liaison group to discuss how the HRFs could have their externalities minimized, but because it used an existing idea of community representation within civil society, the Stammtisch, and this allowed the community to develop a greater level of ownership over the policy-making process. Danielle Bütschi’s chapter evaluates a new form of public participation which again stands somewhat in contradiction to national traditions. She examines the development of the choice questionnaire, a method to involve individuals in complex policy-making issues such as local environmental strat egies, through the use of highly sophisticated self-completion questionnaires. Switzerland stands as a country with highly developed democratic structures and a tradition both of subsidiarity and democratic involvement. Yet what the choice questionnaire appears to highlight is the belief among both academics and policymakers that in order for public participation to be truly meaningful, the citizen must be involved in a process of self-reflection. What is particularly interesting about the choice questionnaire is how this deliberation is centred on the individual rather than the group, as one might expect.

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In Peter Dienel’s chapter on planning cells in Germany we are given a personal insight into one of the most interesting developments in public participation of the last few years. Planning cells were the forerunner of the increasingly popular citizens’ juries and Peter Dienel himself was instrumental in establishing them. They have had an important impact on the local policymaking process in Germany. Peter Dienel’s chapter provides an account of the planning cells process, highlighting how they have used deliberative small group working as an effective means to provide a route through the traditionally expensive and timeconsuming planning consultation process. Developments in public participation within British health policy offer an interesting comparison to the German planning cells. Firstly, the health panels examined by Maggie Mort, Steve Harrison and Therese Dowswell have been developed in what may be termed a democratic vacuum. Health service provision in Britain has undergone significant change over the last decade, with the introduction of a purchaser-provider split and the severing of what weak ties there were into the local representative democratic system. Seeking in part to fill this void, the authors argue that health panels have been dealing with more substantive policy issues than in local government. However, while this may be a cause for optimism, the authors go on to argue that, in reality, public involvement is still limited and panels cannot act as an alternative to appropriate representative structures. The final two chapters take education as their theme. Pekka Kettunen focuses on parent as consumer during the introduction of vouchers in Finland. In doing so, he examines how a Nordic country, with its strong social democratic roots and a tradition of community and collective provision, has come to adopt a market-oriented reform that has been more traditionally associated with neoliberal reform in countries such as Britain. In the final fieldwork chapter, Eva Sørensen examines the influence of parents as governors in the school system in Denmark. Tracing the development of parental influences since the 1970s, she focuses on how they highlight the apparent tensions between individual freedom and political equality. She does this by placing them in a broader context—the three waves of Danish decentralization since the 1970s. The chapter outlines how democracy in primary education is now divided between the local authority and the school, with the school gaining more autonomy in recent years. It concludes by arguing that the reforms will only prove viable if a balance is established between the roles of user and citizen, and alongside this a new relationship between users and professionals. References Asher, K. (1987) The Politics of Privatisation. London: Macmillan. Badie, B. and Dirnbaum P. (1979) Sociolgie de l’Etat. Paris: Grasset.

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Baldersheim, H. and Ståhlberg K. (1991) “Towards the self-regulating municipality’, in Baldersheim, H. and Ståhlberg, K. (eds) Free Communes and Administrative Modernization in Scandinavia. Aldershot: Dartmouth. Blair, P. (1991) “Trends in local autonomy and democracy: reflections from a European perspective’ in Batley, R. and Stoker, G. (eds) Local Government in Europe: Trends and Developments. London: Macmillan. Bogdanor, V. (1992) Local Democracy and the European Community: Challenge and Opportunity. Luton: Local Government Management Board. Burns, D., Hambleton, R. et al. (1994) The Politics of Decentralisation: Revitalising Local Democracy. London: Macmillan. Bütschi, D. and Cattacin, S. (1994) Le Modèle Suisse du Bien-être. Lausanne: Réalités sociales. Clarke, M. and Stewart, J. (1986) The Public Service Orientation: Developing the Approach. Luton: Local Government Management Board. Clarke, M. and Stewart, J. (1991) The Choices for Local Government for the 1990s and Beyond. London: Longman. Cram, L. and Richardson, J. (1992) Citizenship and Local Democracy: A European Perspective. Luton: Local Government Management Board. Elcock, H., Jordan, G., Midwinter, A., Boyne, G. (1989) Budgeting in Local Government: Managing the Margins. London: Longman. Flynn, N. (1993) Public Sector Management. Hemel Hempstead: Harvester Wheatsheaf. Flynn, N. and Strehl, F. (1996) Public Sector Management in Europe. Hemel Hempstead: Harvester Wheatsheaf. Friedman, M. (1962) Capitalism and Freedom. Chicago: University of Chicago Press. Giddens, A. (1998) The Third Way: The Renewal of Social Democracy. Cambridge: Polity Press. Goldsmith, M. (1996) “Normative theories of local government: a European comparison”, in King, D. and Stoker, G. (eds) Rethinking Local Democracy. London: Macmillan. Grunow, D. (1991) “Customer-orientated service delivery in German social administration”, in Batley, R. and Stocker, G. (eds) Local Government in Europe: Trends and Developments. London: Macmillan. Gyford, J. (1991) Citizens, Consumers and Councils: Local Government and the Public. London: Macmillan. Gyford, J., Leach, S. and Game, C. (1989) The Changing Politics of Local Government. London: Unwin Hyman. Hablåtzel, P. and Haldermann, T. (eds) (1995) Umbruch in Polititk und Verwaltung. Ansichten und Erfahrungen zum New Public Management. Bern: Haupt. Hampton, W. (1987) Local Government and Urban Politics. London: Longman. Harvey, D. (1990) The Condition of Postmodernity. Oxford: Blackwell. Hayek, F. (1944) The Road to Serfdom. London: Routledge & Kegan Paul. Hayek, F. (1976) Law, Legislation and Liberty. London: Routledge & Kegan Paul. Hirschman, A. (1970) Exit, Voice and Loyalty. Cambridge MA: Harvard University Press. Hug, S. and Sciarini, P. (1996) “Staatsreform—la réforme des institutions—institutional reforms,” Swiss Political Science Review, 2, 2, 222–58. James, O. and Manning, N. (1996) ‘Public management reform: a global perspective’, Politics, 16, 3, pp. 143–9.

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Klages, H. and Loffler, E. (1996) “Public sector modernisation in Germany—recent trends and emerging strategies”, in Flynn, N. and Strehl, F. (eds) Public Sector Management in Europe. Hemel Hempstead: Harvester Wheatsheaf. Klausen, K. and Ståhlberg, K. (eds) (1997) NPM og Norden. Odense: Odense Universitetsforlag. Kriesi, H. (1995) Le Système Politique Suisse. Paris: Economica. Lafferty, W. and Eckerberg, K. (eds) (1997) From Earth Summit to Local Forum. Oslo: ProSus. Longchamp, C. and Hardmeier, S. (1991) Democratie-Reform und Europäische Frage. Bern: GfS Forschungsinstitut und Universität Bern. McLaverty, P. (1996) The Politics of Empowerment. Aldershot: Dartmouth. Niskanen, W. (1971) Bureaucracy and Representative Government. Chicago: Aldine Atherton. Norton, A. (1987) “Decentralisation in western European cities”, Local Government Policy Making, 14, 2, pp. 13–18. Norton, A. (1991) “Western European local government in comparative perspective”, in Batley, R. and Stoker, G. (eds) Local Government in Europe: Trends and Developments. London: Macmillan. O’Connor, J. (1973) The Fiscal Crisis of the State. New York: St Martin’s Press. Osborne, D. and Gaebler, T. (1992) Reinventing Government: How the Entrepreneurial Spirit is Transforming the Public Sector. Reading MA: Addison-Wesley. Page, E. and Goldsmith, M. (1987) “Centre and locality: explaining cross-national variations”, in Page, E. and Goldsmith, M. (eds) Central and Local Relations: A Comparative Analysis of West European Unitary States. London: Sage. Papadopoulos, Y. (1995) “An analysis of the functions and dysfunctions of direct democracy: top-down and bottom-up perspectives”, Politics and Society, 23, 4, pp. 421–48. Pollitt, C. (1990) Managerialism and the Public Services. Oxford: Blackwell. Pollitt, C., Hanney, S., Packwood, T., Rothwell, S., Roberts, S. (1997) Trajectories and Options: An International Perspective of the Implementation of Finnish Public Management Reforms. Helsinki: Ministry of Finance. Ridley, F. (1996) “The new public management in Europe: comparative perspectives” Public Policy and Administration, 11, 1, pp. 16–29. Stoker, G. (1991) The Politics of Local Government. London: Macmillan. Strehl, F. and Hugl, U. (1996) “Switzerland”, in Flynn, N. and Strehl, F. (eds) Public Sector Management in Europe. Hemel Hempstead: Prentice Hall. Villadsen, S. (1993) “Another century for local democracy? Decentralisation, deregulation and participation in Scandinavia in times of European integration”, International Journal of Urban and Regional Research, 17, 1, pp. 42–55. Weir, S. and Hall, W. (eds) (1994) Democratic Audit: Extra-governmental Organisations in the United Kingdom and their Accountability. London: Charter 88 Trust. Wilks, S. (1996) “Sweden”, in Flynn, N. and Strehl, F. (eds) Public Sector Management in Europe. Hemel Hempstead: Harvester Wheatsheaf.

CHAPTER TWO Towards a Model of Public Participation Peter McLaverty

Introduction There have been moves in a number of European and other advanced capitalist societies in recent years to devolve government functions in addition to or as an alternative to increasing citizen participation in public affairs. Many of those initiatives have been underpinned by the aims of managers in the public sector to maximize community support for the policies they ultimately implement and to improve the standard of services provided. In other words, initiatives have been promoted by the instrumental aims of managers and not by a desire to increase popular power, as an end in itself. As outlined in Chapter 1, introducing market or market-type mechanisms into the provision of public services has also been followed in a number of countries. Over the years, theorists have produced models of participation. Some have tried to explain why people do or do not take part in various participation initiatives. Others have tried to explain how different participation exercises relate to goals of control, empowerment or democracy. Those theoretical considerations are particularly apposite, given the current agenda of public policy-makers across the World. In this chapter I will evaluate some of the more well-known theories which try to explain how participation exercises relate to goals of control, empowerment or democracy. I am concerned with trying to develop a model (or matrix) which helps to explain whether different methods of public participation contribute to the development of democracy and collective, or individual empowerment. (The development of this matrix was first considered at the ECPR seminar on innovative systems for political dialogue between governments and citizens, held in Oslo during 1996.) In developing what we have termed the public involvement matrix, I will first set out a working definition of democracy and consider what empowerment means in practical terms. I will then examine the analytical frameworks of Arnstein and Hirschman, along with the discourse ethics of Habermas and the work of Laclau and Mouffe, as well as theorists who see empowerment as best developed through the workings of market forces. The discussion in this chapter will try to show there are crucial tensions within liberal democracy between the individual and the collective on the one hand, and the particular and

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the universal, on the other. The way in which a number of writers and schools of thought have tried to negotiate those problems will be considered. The strength of the public involvement matrix, set out towards the end of the chapter, is that it provides a means of analyzing the ways in which participation initiatives reflect the tensions inherent in liberal democracy. Democracy and Empowerment Defined Democracy can be seen as an “essentially contested” concept. Certainly, a number of governments and states with strikingly different characteristics regard themselves as democracies. My aim, however, is not to examine the different theoretical approaches to democracy, or to categorize the regimes which define themselves as democratic. Rather, my objective is to produce a rigorous working definition of democracy which can be used as a benchmark against which to judge different participation initiatives. For many writers, “democracy” means some form of collective control or popular power. For Anthony Arblaster (1994:9), “At the root of all definitions of democracy, however refined and complex, lies the idea of popular power, of a situation in which power, and perhaps authority too, rests with the people”. That view resonates with the definition put forward by Frank Cunningham (1994:35), “Crudely summarised, I think democratic progress has been made when more people come to have control over a shared social environment than had previously been the case”. A third view, which again accepts that the nature of democracy is collective control, is that advanced by David Beetham (1993), who sees democracy as the making of collectively binding rules, which apply to all. Beetham writes: Democracy I take to be the mode of decision-making about collectively binding rules and policies over which people exercise control, and the most democratic arrangement to be that where all members of the collectivity enjoy effective equal rights to take part in such decisionmaking directly—one, that is to say, which realises to the greatest collectivity degree the principles of popular control and equality in its exercise. (Beetham 1993:55) None of the above writers specify directly the areas within which democracy can legitimately be exercised. However, they all seem to take a fairly broad view. For those writers, democracy is not simply something that applies to the formally political sphere. Indeed, Arblaster (1994) directly writes about the struggle to create a democratic society. The implication, in all the approaches outlined above, is that any area of society in which collectively binding rules are developed is suitable for the application of democratic structures and procedures. Democracy, in those views, is not simply about electing people to parliament or regional or local councils.

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If democracy, therefore, is about collective control or the exercise of popular power, how does that relate to ideas of empowerment? Burns et al. (1994) argue there are two broad ways of approaching the concept of “empowerment”. First, there is the approach associated with the so-called New Right. Writers included under this generic term do not share identical views. However, while there are variations in the emphasis they give to different factors, there is a core approach to which the writers conform. Common to all New Right writers is the argument that freedom or empowerment is best developed through enabling people to exercise personal, individual control. That individual control is best exercised through market forces. People can become empowered by taking their custom to the organization that best satisfies their requirements. If someone is dissatisfied with the service he or she is receiving, he or she should be free to take their custom elsewhere. As Gordon Tullock has put it, “In the market place we do not try to discover the cost structure of companies from whom we buy products or services. All we do is compare the best prices and services offered by organisations and choose the one that suits us best” (1994:117). For public choice theorists, services provided by public sector organizations have a strong tendency to be delivered in a paternalistic or even an oppressive manner. Consumers of services provided by the public sector are, on the whole, given little chance to exercise either freedom or choice. Such services are under the sway of provider control. Public bureaucrats, be they administrators, teachers, hospital doctors, social workers, social security clerks or whatever, control the process of service provision in ways that protect and further their interests at the expense of service consumers. And as the New Right politician and former British prime minister Margaret Thatcher never tired of saying, monopoly state provision can produce dependency among consumers of services or recipients of benefits. Moreover, traditional state provision leads to the oversupply of goods and services, which rarely meet people’s needs in any case. The answer to these problems, for public choice theorists, is to remove state provision entirely, if possible, and bring in private providers, who have to follow the laws of supply and demand and the rigours of the market. Where this is not possible, state monopoly should be ended and consumers given the chance to move between different providers, through the creation of competing suppliers and the development of voucher schemes which customers will be able to take to different providers (Self 1993). The second route to empowerment which Burns et al. (1994) identify is through public participation in organizations. This route involves people being able to influence decisions within organizations and using that ability to exercise power. Rather than reacting to events, by taking their custom elsewhere if they are not happy, people become involved before the event, in trying to ensure beneficial outcomes; or they become involved after the event, in trying to sort out any problems. People become involved in the working of the organization to influence events, rather than moving around the market.

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The two views of empowerment are discrete, although it is possible, as Burns et al. argue, to envisage the two approaches working in combination. In broad terms, the first approach is individualistic and the second is collectivist. The two approaches relate to Hirschman’s distinction between exit and voice. It is worth considering Hirschman’s work in this area, for his approach helps to clarify the two approaches to empowerment outlined by Burns et al. His distinction will feed directly into, and inform, the public involvement matrix set out later. His approach also connects to broad positions adopted recently by governments in many European countries. Hirschman’s Approach Hirschman distinguished between two ways of trying to exercise power in one’s dealings with organizations—voice and exit. He also mentioned loyalty, where people stay with an organization, despite having little control or influence over what the organization does, or how it does it, because they see little alternative. In this chapter, however, I will focus on his argument in respect of the advantages and disadvantages of voice and exit options. For Hirschman, voice options spring from the arena of politics, while exit options spring from the arena of economics. He distinguishes between the two models of “empowerment”, as follows: Exit is the sort of mechanism economists thrive on. It is neat—one either exits or does not; it is impersonal—any face-to-face confrontation between customers and firm with its imponderable and unpredictable elements is avoided and success and failure of the organisation are communicated by statistics; and it is indirect…. In all these respects voice is the opposite of exit. It is a far more ‘messy’ concept because it can be graduated…; it implies articulation of one’s critical opinions rather than a private, ‘secret’ vote in the anonymity of a supermarket; it is direct and straightforward rather than roundabout. (Hirschman 1970:15–16) Exit involves simply taking your custom elsewhere, if you are dissatisfied. For that to happen there need to be alternative providers or suppliers of goods or services and one needs the wherewithal to take advantage of the alternatives. For example, if the alternative supplier or suppliers only provide the good or service at a price which you cannot afford, then the exit option is fairly hollow. Similarly, if you cannot reach any of the alternative suppliers physically because they are too distant from where you live, the exit option hardly exists. The same applies if you lack information about the existence of alternative suppli ers. Nor does the exit option exist where there is only one monopoly supplier. Moreover, as Burns et al. (1994) argue, services such as street lighting only apply to groups of people, not to individuals. As a result, no matter how good the exit option may

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be in theory, in reality there will always be circumstances where it does not exist for some people. However, those who support the exit option as a means of personal empowerment, argue that it enables people to make choices for themselves, rather than being reliant on bureaucrats, so-called experts, monopoly suppliers or collective decisions where they may disagree with the decision taken. The exit option, it is argued, also encourages suppliers to be more responsive to their customers for fear of losing out to other suppliers. Expanding or introducing market or market-type mechanisms into services which were previously under monopoly state control will increase efficiency and help to empower consumers. Providers will know that they need to keep within budget constraints and that if they do not produce good quality services, customers can take their custom elsewhere. In the process, customers will be empowered and given the chance to ensure needs are met in an efficient and effective way. As a method of personal empowerment, the voice option is seen as having certain specific drawbacks. Individual voices within a large organization are likely to get lost, it is argued. Unless one has a powerful position in the organization, one’s effect on policy is likely to be extremely small, even if one puts in considerable effort. Collectivities of people may be able to have more affect on decision making. However, it is sometimes difficult to find people who share your exact approach to an issue. Some people often do not have the time that the effective use of the voice option often demands. Moreover, to be effective, the voice option often demands that people are able to articulate their concerns and opinions. It tends to favour the articulate and those who are prepared and able to stand up to authority. Just as the exit option can be seen as possibly discriminating against the poorer members of society, so the voice option can be seen as possibly discriminating against the less articulate, less confident and those with less time. However, writers who support the voice option argue that the exit option is often a blunt weapon. There is no guarantee that alternative suppliers will be any better than the one currently used. Action can only be taken after the event. The pure exit option leaves people with no way to remedy any past problems. But the voice method, if it is effective, gives people a way of influencing future developments and trying to remedy past failings. Service users want the existing provider of the services to perform better, rather than having the often illusory opportunity to transfer to another supplier. Creating structures where collective user and/or community involvement is a reality, whatever difficulties there may be in bringing that about, thus offers a better hope of meeting people’s needs than relying on the individualism of the market, with all its attendant inequalities, it is argued. While there have been initiatives by governments in a number of European countries to strengthen exit options, efforts have also been made to create mechanisms which increase people’s voice in the running and development of public services. Innovations which fit within those categories are

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the subject of this book. Theorists have tried to produce models which will enable the mechanisms introduced to be systematically analyzed. One of the most influential models was produced by Sherry Arnstein in the early 1970s. It is important to examine Arnstein’s approach, for it represents an effort to model public participation initiatives in terms of the development of citizen control or power. Evaluative Models in Context Arnstein (1971) developed her analytical model of citizen participation in response to the development of federal social programmes in the US in the 1960s, programmes based on the idea of maximum feasible participation. After considering the different programmes associated with the Kennedy and Johnson administrations, she produced an eight-rung ladder showing different levels of participation. The ladder would enable federal programmes to be placed on the appropriate rung and clearly analyzed in terms of the degree of participation they allowed or promoted. Arnstein considers the bottom two rungs (manipulation and therapy) as examples of non-participation. The next three rungs (information, consultation and placation) are degrees of tokenism. By that Arnstein means they are mere genuflections to participation and have no affect on issues concerning the exercise of power or control. The three highest rungs (partnership, delegated power and citizen control) represent what Arnstein calls degrees of citizen power. On those rungs, citizens gain real power over certain areas or issues. Arnstein’s ladder has become one of the most well-known models of participation. However, the model has been criticized from a number of angles. Burns et al. (1994) argue that it fails to distinguish clearly between participation and control. The model is also seen as artificially limiting the options for participation at the higher rungs. Moreover, it is claimed, again by Burns et al., that the rungs on the ladder should not be the same distance apart, as they are in Arnstein’s model. The moves from one rung to the next do not have the same degree of difficulty; some are harder than others. Burns et al. (1994) distinguish between three areas of decision making: operational practices, expenditure decisions and policy-making. Public organizations may be happier conceding some form of control to users over decisions on operational matters than they are over matters of resource expenditure or, particularly, over policy making. It is therefore important to distinguish the area of the policy process in which decisions are being taken, in order to understand the implications of any participation initiatives. Taking these criticisms into account, they come forward with their own revised ladder of participation. For Burns et al., the lowest four rungs of their ladder (civic hype, cynical consultation, poor information, customer care) represent forms of “citizen nonparticipation”. They are largely illusory methods which make a show of participation. The next six rungs (information, consultation of high quality,

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genuine advisory bodies, effective decision making, limited decentralization, control in the form of partnerships between the public body and citizens) all represent forms of citizen participation. On those rungs, citizens can participate in decision making on a meaningful basis with those who run public organizations. Finally, a number of rungs are distinguished, which enable citizens to exercise different degrees of control. Burns et al. distinguish between different forms of citizen control. Delegated control is very much part of citizen participation, for the managers and controllers of organizations retain power over the control citizens are able to exercise. But along with independence, other forms of control, such as entrusted control, are seen as forms of real citizen control, where citizens are able to determine their own agendas and their own ways of working. The difference between the Burns et al. model and the Arnstein model is partly one of language. The Burns et al. model does show greater sophistication at the higher rungs of the ladder, as well as distinguishing usefully between citizen participation and citizen control. However, criticisms can be made of this approach too. One of the main problems is the terminology, especially in the lower rungs. Burns et al. use a language which is highly value-laden. Terms like civic hype, cynical consultation and poor information foreclose debate about whether certain methods are really aimed at developing citizen participation or control. I have no doubt that public organizations manipulate the idea of public participation for their own purely instrumental ends, with no intention of involving citizens in decision making. But it is not clear how the type of emotive language Burns et al. use to analyze “participation” initiatives is particularly helpful. Moreover, Burns et al. talk about genuine advisory boards, and effective decision making. Both those concepts are open to wide interpretation and are likely to lead to heated debates about where “participation” initiatives are to be placed, with analysts trying to interpret the intentions of those sponsoring the initiatives. This is not to denigrate the use of such evaluative tools. However, I would like to suggest that alternative methods, such as the public involvement matrix outlined at the end of this chapter, may offer another means to assess participation, particularly in terms of its ability to enhance democracy or promote empowerment. Taking the relationship between participation and democracy first, we need to define more clearly how the popular power or collective control associated with democracy might be realized in practice. This involves defining more clearly the elements which comprise democracy and empowerment and their relative importance. A strand in democratic theory argues that the discursive and deliberative elements of democracy should be given greater prominence, as they are crucial to assessing the workings of democratic initiatives. I will therefore consider in some depth the work of Jürgen Habermas and his idea of discourse ethics plus the work on radical democracy of Ernesto Laclau and Chantel Mouffe. This consideration will evaluate the normative, theoretical and empirical

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factors contained in the approaches to democracy of Habermas, Laclau and Mouffe, then feed into an elaboration of the public involvement matrix. Discourse Ethics, Democracy and Public Participation Norberto Bobbio argues that the important point in distinguishing democracies from other forms of rule, is not so much who makes decisions but how decisions are made. According to Bellamy (1986:9), Bobbio produces a critical but not hostile reading of Marx’s legacy, which argues that Marx largely “ignored the question of how power is exercised by concentrating on who holds it” (italics in original). For Bobbio, that was a major mistake, since the important issue in political theory, in respect of governing, is what procedures are used by, or imposed upon, those who govern. If those who take decisions are genuinely accountable to the collectivity at large, for Bobbio, it does not matter from which class or group those making the decisions emanate. Where governors are genuinely accountable to the collectivity and represent the wishes of the people, for Bobbio, democracy exists. Of course, Bobbio argues that for democracy to exist, all eligible people must have an equal right to decide who they want to govern them and there must be clear mechanisms for the people to hold their governors regularly accountable. However, democracy is seen very much as a matter of procedures, rather than substantive outcomes. For Bobbio, simply having people from the largest class in society governing or having people form disadvantaged minorities included in the government or public decision-making structures will not necessarily produce either democracy or good government. For you can have autocracies where members of the largest class or the most disadvantaged minorities govern. The important point is how they govern (Bobbio 1986). Offe and Preuss (1990) also argue that democracy basically involves a concern with procedures. However, unlike Bobbio, they argue that the types of decision are crucial. For them, democracy is not simply about all having the equal right to participate in elections or governmental procedure, though that is recognized as a crucial element of democracy. They argue that for democracy to work properly, to fulfil its potential, people must reflect seriously on the issues involved, before they act, either as voters or decision makers. This approach would call into question the focus on improving service efficiency which underpins many of the participation initiatives introduced by states in recent years. Offe and Preuss write: In our view, what remains after both the individualistic and the solidaristic visions [of democracy] have lost much of their persuasiveness is the conclusion that the institutional designs of modern democracy must be based upon the principle of reciprocity. This principle would require that democratic theorists—as well as the everyday practitioners of democracy— place greater emphasis upon the institutional settings and procedure of

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preference formation and preference learning in civil society. (Offe and Preuss 1990:169) The argument that Offe and Preuss are advancing is that democracy will only work well, in modern society, if people are willing and able to listen to different arguments and positions from the ones that they currently hold. The basis on which people act is crucial for Offe and Preuss. Democratic procedures should encourage and enable people to think and to question their views and outlook before they act. They argue that institutions should upgrade the quality of citizenship by putting a premium on refined and reflective preferences, rather than ‘spontaneous’ and contextcontingent ones. By reflective preferences we mean preferences that are the outcome of a conscious confrontation of one’s own point of view with an opposing point of view, or of the multiplicity of viewpoints that the citizen, upon reflection, is likely to discover within his or her own self. (Offe and Preuss 1990:170) Simply instituting formal political equality will not be enough to fulfil democracy’s potential. More is needed, though Offe and Preuss give few details about the form or forms a deliberative type of democracy might take. However, the work of Offe and Preuss relates directly to the “discourse ethics” approach developed by Jürgen Habermas. Habermas and Deliberative Democracy While Habermas has always seen himself as working within the tradition of historical materialism, his work does show considerable differences from most varieties of Marxism, even from the critical theory with which he is associated. Moreover, in trying to analyze Habermas’s contribution to democratic theory, problems arise because his positions on some key issues have developed and changed quite significantly over time. As his work has progressed, Habermas has increasingly moved away from the traditional Marxist concern with the oppressive and liberating potentialities of human labour. Instead, he has focused on the nature and potentialities of discourse and communication in society, allied to the construction of theories about moral development and the colonization of the lifeworld by the system (Habermas 1984, 1988, 1990, 1991; Outhwaite 1994). The commitment to discourse ethics expressed by Habermas is closely connected to his notion of “communicative competence” and his argument that people can be the bearers of such competence. Habermas argues there are conditions which make communication possible and intelligible. Habermas distinguishes between perlocutionary and illocutionary forms of speech. Perlocutionary speech is concerned with strategic action, i.e. trying to get others

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to help you achieve your goals; illocutionary speech is concerned with the endeavour to reach understanding. Illocutionary speech involves our putting forward statements which are open to scrutiny as to their validity. We put forward claims to truth which can be challenged. As Habermas puts it: In seeking to reach an understanding, natural-language users must assume, among other things, that the participants pursue their illocutionary goals without reservations, that they tie their agreements to the intersubjective recognition of criticizable validity claims, and that they are ready to take on the obligations resulting from consensus and relevant for further interaction. (Habermas 1996:4) Springing from the notion of communicative competence and rationality, Habermas developed the idea of the ideal speech situation. Habermas does not use the term regularly in his work and it is easy to overplay its importance in his overall schema (Ray 1993). That said, Ray has argued that: It is important to stress that the consensus presupposed by communicative action is hypothetical, referring to the conditions which would obtain if all conditions of ideal speech were met, which would effectively signal the completion of human understanding. (Ray 1993: 28) That is something, Ray argues, no one expects to happen. However, the notion of the ideal speech situation does enable one to see how Habermas’s broad ideas relate to democracy, even if the ideal speech situation, as Habermas accepts, is not totally attainable in practice. The ideal speech situation is constructed on the basis of an assumption that it is possible for people to enter into dialogue with the aim of reaching an agreement about what is in the best interests of everyone. The notion demands an acceptance that the common good exists and that it can be reached through undistorted communication. For that to stand any chance of happening, however, a number of conditions must be met. First, people must enter the dialogue prepared to be swayed only by the strength of the arguments put forward. Second, for that to happen, there must be equality of power and influence between the dialogue participants. In other words, it should be impossible for those who have greater social power to impose their views or arguments on others, simply because of their positions in society. Third, the dialogue must be open to all shades of opinion and all participants should be enabled to play a full part in the dialogue. For Habermas (1995) it is through the advancement of those factors that progress towards justice will be made. However, it can be questioned whether the type of equality Habermas sees as necessary for the achievement of undistorted communication can be brought about. This point relates to a wider issue of whether any of the initiatives evaluated in this book can hope to be successful if there is large-scale inequality in society.

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Habermas has increasingly moved away from a concern with questions of social equality. It is no longer clear whether he believes social equality is a necessary condition for discourse ethics to work, based on the ideal speech situation. He certainly writes less about the relationship between discourse ethics and social relations in the wider society. However, Habermas does argue that the rational internal structure of communicative action, required for discourse ethics, conforms to the following characteristics: (a) the three world-relations of actors and the corresponding concepts of the objective, social and subjective worlds; (b) the validity of claims of propositional truth, normative rightness, and sincerity and authenticity; (c) the concept of a rationally motivated agreement, that is, one based on the intersubjective recognition of criticizable validity claims, and (d) the concept of reaching understanding as the co-operative negotiation of common definitions of the situation. (Habermas 1984: 137) Through the ideal speech situation, discourse ethics and his theory of communicative action, Habermas has developed a procedural definition of democracy and justice. For Habermas, decisions are valid in terms of justice, if no group in society could feel that their views and interests had been ignored. Habermas (Habermas 1995:157) has written, “For a norm to be valid, the consequences and side-effects its general observance has for the satisfaction of each’s particular interests must be freely acceptable to all”. In another work, he has said that, “I started with a principle…that the only regulations and ways of acting that can claim legitimacy are those to which all who are possibly affected could assent as participants in rational discourse” (Habermas 1996:458). In other words, Habermas argues that procedures of collective rule making should be based on discussion in which all voices and interests which will be affected should be fully involved and which are in line with the common good. However, it is important to note that in his latest major work, Between Facts and Norms, Habermas (1996) has shown a greater willingness to accept procedures of majority decision making in his consideration of the role of law in society. As David Ingram has written: Habermas himself now suggests that majoritarian procedures are the decisive factor in legitimising laws. If consensus continues to play a role here, it is as a procedural guideline: all parties to the discussion should strive to reach agreement on a common good as disinterestedly as possible —a qualification that by no means precludes the assertion of particular interests. (Ingram 1995:232)

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Limitations of the Habermasian Model Habermas’s approach has been criticized from a number of different angles, and I will consider some of them. There are some who argue that the ideal speech situation and discourse ethics adopt an overrationalistic view of justice and democracy (Meehan 1995). There have been long-running debates about the extent to which people are rational beings or can become rational beings in suitable circumstances. Whatever the correct outcome of that debate, it is difficult to see how arguments for democracy can stand up if people are not in some sense rational. Another criticism of Habermas’s position relates to its cultural specificity. Warnke (1992), for example, argues that Habermas’s approach depends upon a value consensus about the desirability of rational discussion. His approach basically depends upon the widespread acceptance of liberal values. In most European societies, where there is cultural and value diversity, it is argued that Habermas’s approach faces real difficulties. Part of the Habermasian approach involves a belief that consensus, based on universal human interests, is attainable, though his stress on this point may have been reduced in his recent work (see above). However, a number of writers, such as Young (1990), deny that universal human interests either exist or that the idea is a desirable one; this point will be re-examined in connection with the work of Chantel Mouffe. Finally, Habermas is seen as neglecting the issue of social inequality, especially in his later work (Calhoun 1992). It is argued that without social equality you cannot hope to achieve equality in the ideal speech situation. Classical Marxists would criticize Habermas for underestimating the importance of labour, for lacking a theory of “agency” and for suggesting that the lifeworld can ever be isolated from the distorting influence of the capitalist economy and the power exercised by the private owners of the means of production in capitalist society. Other writers, such as Foucault (1980), would argue that the whole idea of “undistorted” communication is profoundly mistaken, in that it misunderstands the nature of “power”. Power, for Foucault, suffuses social relations and those who, in the accounts of some, are said to exercise power, such as capitalist managers and professionals, are also caught in the web of power. For they come to be imprisoned, by becoming dependent upon the mechanisms through which they purportedly exercise their power. As Dyrberg (1997) argues, power assumes a circular form, in which all participate. Moreover, in some readings of Foucault (Walzer 1986), power relations cannot be avoided and the transparency and openness which Habermas sees as a goal is consequently unachievable. Even in less bleak readings of Foucault, the nature of power is such that the achievement of “discourse ethics” may well be impossible. Foucault does not deny that people resist power, but he contends that one cannot hope to be liberated from power. As power, for Foucault, has no centre, the most we can hope for is ongoing resistance to, and struggles against, power in specific local arenas (Bird 1989).

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These criticisms all contend that Habermas’s ideas are unworkable, undesir able or both. It is certainly difficult to refute the arguments that discourse ethics is unachievable, for there are few examples of attempts which have been made to put discourse ethics into affect (Blaug 1997). The examples where writers argue that communicative action has been made to work, such as Schlosberg (1995) in his analysis of the Alternative Dispute Resolution movement and the Direct Action movement, are fairly small-scale and/or limited in their scope and transferability. The same can probably be said about the examples used by Dryzek (1994). In this book, Peter Dienel and Daniel Kübler analyze two efforts to increase discourse in the public policy process. In different ways both methods encourage discourse between citizens. However, whether they meet the strict criteria associated with discourse ethics is questionable. Moreover, Habermas himself does not give details or describe how the type of democracy implied by discourse ethics can be put into practice. As far as desirability is concerned, the issue revolves around whether one believes that inclusive and consensual collective rule making is a good thing and whether one believes that, if possible, it would produce good outcomes. In support of the desirability of Habermas’s position, Thomas McCarthy has argued: The idea of arranging our lives together on the basis of uncoerced agreements, arrived at in free and equal exchanges, by considering reasons pro and con, is not the depiction of any concrete utopia. But neither is it empty: whether individuals and societies are committed to this idea makes an enormous difference. (McCarthy 1994:224) The suppositions that “discourse ethics” is possible and desirable are directly questioned by Chantel Mouffe, who has written: While sharing with us the critique of the traditional conception of socialism, those forms of radical or participatory democracy [associated with Habermas] belong to another philosophical universe and these theoretical divergences have important political consequences. Those universalistic versions of radical democracy…require the availability of an ‘undistorted communication’ and of a final rational reconciliation of value claims. In other words, they envisage the possibility of a politics from which antagonism and division would have disappeared. Our understanding of radical democracy, on the contrary postulates the very impossibility of a final realisation of democracy. (Mouffe 1992:13) Laclau, Mouffe and Radical Democracy Discourse ethics may be one way of trying to deal with the inherent tensions in liberal democracy between the individual and the collective, between the particular and the universal. It may also provide a basis for evaluating

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the democratic potential of public participatory initiatives. However, there are other approaches which may perform similar functions. One such, which I now want to consider, is that advanced by Ernesto Laclau and Chantel Mouffe. Laclau and Mouffe (1985) argue that traditional Marxist views of social change have proved flawed because they fail to take account of the necessary plurality that exists in capitalist society. They also contend that Marxist views are based on a number of unsustainable universalisms, particularly that concerning the current position and future actions of the working class. They argue that since it was forced to abandon many of its crude universalistic ideas, Marxism has been wracked by a series of dualisms, which are equally insupportable. For Laclau and Mouffe, a crucial distinction has to be made between the existence and being of things. Being or identity, for Laclau and Mouffe, is always discursively constructed and necessarily unstable: If all identity is differential it is enough that the system of differences is not closed, that it suffers the action of external discursive structures, for any identity to be unstable. That is what shows the impossibility of attributing to the being of things the character of a fixed essence, and what makes possible the weakening of form, which constituted the cornerstone of traditional metaphysics. Human beings socially construct their world, and it is through this construction—always precarious and incomplete—that they give to a thing its being. (Laclau and Mouffe 1987:89) For them, discourse is the essence of human life. There can be no certainty about the outcomes of discursive processes because there is no essential human being that can be the basis of definitive outcomes. Interests are constructed by human beings through discourse. Those interests can, and do, change in line with the effects of discourse. Laclau and Mouffe, therefore, deny that there is any ontological reason why people should be able, or wish to, achieve consensus, as a result of undistorted communication. Mouffe has further argued that we need a problematic that conceives of the social agent not as a unitary subject but as the articulation of an ensemble of subject positions, constructed within specific discourses and always precariously and temporarily sutured at the intersection of those subject positions. (Mouffe 1992:237) For Mouffe, even the most democratic politics necessarily involves conflict which results from inescapable human diversity. In this view, politics revolves around public and collective action. Although our identities and being are discursively constructed, and Mouffe argues that democratic methods are the most appropriate means of constructing people’s identity, the oppositional elements of democracy can never be avoided. As she has written:

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Political life concerns collective public action, it aims at the construction of a ‘we’ in a context of diversity and conflict. But to construct a ‘we’ it must be distinguished from the ‘them’ and that means establishing a frontier, defining an ‘enemy’. (Mouffe 1992:234–35) Shortly afterwards she adds: Antagonistic forces will never disappear and politics is characterised by conflicts and division. Forms of agreement can be reached but they are always partial and provisional since consensus is by necessity based on acts of exclusion. (Mouffe 1992:235) The search for Habermasian consensus is therefore a delusion. Indeed, according to Torfing (1997), Laclau and Mouffe believe there can never be a consensus around an absolute common good, and that is what makes democracy possible. If a universal common good existed then democracy, it is argued, would become unnecessary. But some writers, such as Mark Neocleous (1996), have questioned how far the depiction of politics as a friend-enemy contest is compatible with support for the inclusiveness associated with democracy. Does not democracy, at its very essence, involve a belief that some kind of consensus is ultimately possible? Moreover, Neocleous is troubled by Mouffe’s appropriation of Carl Schmitt’s work in relation to democracy. Schmitt developed the argument that politics involves the friend-enemy distinction, and Laclau and Mouffe take up this position. However, Schmitt’s own democratic credentials are seen as very weak because of the authoritarianism associated with his whole approach. Mouffe accepts that concepts of the common good, civic virtue and political community are important to what she and Laclau term “radical democracy”. However, she also argues that such ideas, based around some collective idea of unity, will always be in tension with other ideas, which stress the plurality of social identity and the precariousness of collectivities. The individual and his or her multiple identities must not be subsumed under shifting and artificial collective forms. Mouffe writes: Radical democrats agree on the need to recover such ideas as ‘common good’, ‘civic virtue’ and ‘political community’, but believe that they must be reformulated in a way that makes them compatible with the recognition of conflict, division and antagonism. (Mouffe 1992:12). Democracy will always produce indeterminate and uncertain results. Identities will always be renegotiated and reconstructed in democratic politics. Such politics will always be open, reflecting “a conscious movement of differences” (Townsend 1996:244). The aim of radical politics is not, therefore, to attempt to reach a consensus but to construct collectivities of us as against them. As a result, Mouffe is directed to support a pluralist democracy, which can

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accommodate a commitment to what in Hirschman’s terms would constitute the exit option. Laclau and Mouffe’s work has had its critics; one of the most far-reaching criticisms has been made by Norman Geras (1987). Geras argues on a number of fronts. For him the notion that identity and being are totally indeterminate is a position that even Laclau and Mouffe cannot sustain. There has to be some fixity for social theory to be meaningful: But if there were truly no fixity, thoroughgoing social indeterminacy and that is all, there would be nothing more of consequence for the putative social theorist to say, a fact which Laclau and Mouffe have duly to acknowledge, with the concession, “a discourse incapable of generating any fixity of meaning is the discourse of the psychotic”. (Geras 1987:71) Also of interest, from the perspective of this chapter, Geras argues that the dismissal of universal ideas leaves Laclau and Mouffe with no real grounding for a commitment to justice or, one might logically suppose, concepts of a similar kind, like democracy. He makes his point thus: A theoretical perspective in which “the era of universal discourses” has “come to an end”, can have no more room for a trans-historical, universalist notion of justice, than it can for the concept of a universal human nature—always assuming some minimal effort of intellectual consistency. (Geras 1987:76) Moreover, Geras criticizes Laclau and Mouffe for having very little to say about the actual form taken by the radical democracy they support. Similar criticisms have been levied at Habermas, as I showed earlier. The Public Involvement Matrix The important point here is that, while they have different reasons for reaching it, Habermas and Laclau and Mouffe, stress the importance of an inclusive, radical or participatory democracy, and give ideas about how public participation initiatives can be judged in terms of their democratic potential. In that sense, both approaches contribute to the construction of a matrix which helps to analyze the different initiatives set out in this book. Indeed, despite their major differences, all the approaches discussed in this chapter reflect the tensions within liberal democracy, between the individual and the collective and the particular and the universal, though they differ fundamentally about how the tensions should be resolved. As such, the approaches enable a matrix to be constructed. The strengths and weaknesses of the different initiatives can then be analyzed in terms of their potential for empowerment, according to where they fall on the matrix. This is unlike the work of Habermas, Laclau and Mouffe, and others

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discussed above. While the matrix can be used purely as an analytical tool, which enables different initiatives to be placed in the appropriate cells, it can also be used to determine how far an initiative has fulfilled a normative commitment. In doing so it represents and crystallizes the major disputes in the discussions about the content and institutionalization of liberal democracy. Though individual writers in this book are committed to the extension of democracy in various ways and for various reasons, the matrix’s usefulness in no way presupposes such a commitment. The matrix is therefore analytical without being prescriptive. In the matrix, it is argued, there are four components one can use to analyze the type of initiatives described and examined in this book: collectivism, individualism, particularism and holism. Initiatives can be defined on two axes. Either an initiative is broadly collective or it is individual in its approach. Similarly, each initiative can be holistic or particularistic. Here are some definitions: • Collectivist: everyone who is likely to be affected by a policy decision, or the area under consideration, should have an equal input into the policy decision. • Individual: people, as individuals, are able to participate in and to decide (partly if not wholly) the type of service they will be able to use. • Holistic: the way in which decisions are made encourages people to think in terms of some notion of the common good or general interest. • Particularistic: the way in which decisions are made in the area concerned encourages people to think in terms of particular or self-interest. Figure 2.1 illustrates the model. The cells in the matrix are not put forward as totally mutually distinct and self-contained. It is accepted there can be some overlap between the different cells. For example, a user board which was set up to cover a particular school would be defined as collective but particularist, in that it treated parents collectively but was concerned only with the parents of children in the one particular school, with the consequence that parents would only be expected to think in terms of what was best for the children in their particular school, rather than considering the interests of all children within the locality. On the other hand, if each school in a locality set up a user board, and each board was able to elect representatives to an authority which had overall control for all schools in the locality, then the particularist school boards would fit into a holistic structure, in which parents would be expected to think in terms of what was in the best interest of all children in the locality, not just those attending a particular school. As a result, parents would engage in collective, particularist and holistic activities. It is also possible for initiatives that fall into different cells to be used in combination. For example, parents might be given vouchers to pay for the education of their children in school. The parents would be free to use the vouchers at any school of their choice, provided the school was prepared and/ or able to accommodate the child. In that case the initiative would be individual and

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Figure 2.1 The public involvement matrix.

particularist, for parents would be encouraged to think simply in terms of what was best for their individual children. However, in addition, schools might establish “user” boards, an initiative which would be collective and particularist, for reasons given above. Finally, the school user boards might be able to elect representatives or delegates to an authority which had overall control for schools in the locality. In that case the initiative would be collective and holistic, as shown earlier. The flexibility of the public involvement matrix is taken up in the concluding chapter. Some of the initiatives fall within the exit component of influence and aim to empower people as individual consumers. They take on board the type of arguments propounded by public choice theorists. Most of the initiatives, however, are in line with the voice option and aim to empower people collectively through the use of democratic methods. I hope the theoretical approaches outlined in this chapter, and the criticisms, will help readers to determine the strengths and weaknesses of the various initiatives. References Arblaster, A. (1994) Democracy. Buckingham: Open University Press. Arnstein, S. (1971) “A ladder of participation in the USA”, Journal of the Royal Town Planning Institute, April, pp. 176–82.

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Beetham, D. (1993) “Liberal democracy and the limits of democratisation”, in Held, D. (ed.) Prospects for Democracy. Cambridge: Polity Press, pp. 55–73. Bellamy, R. (1986) “Introduction”, in Bobbio, N. Which Socialism? Cambridge: Polity Press. Bird, J. (1989) “Foucault: power and politics”, in Lassman, P. (ed.) Politics and Social Theory. London: Routledge. Blaug, R. (1997) “Between fear and disappointment: critical, empirical and political uses of Habermas”, Political Studies, 45, 1, pp. 100–117. Bobbio, N. (1986) Which Socialism? Cambridge: Polity Press. Burns, D., Hambleton, R., Hoggett, P. (1994) The Politics of Decentralisation: Revitalising Local Democracy. London: Macmillan. Calhoun, C. (ed.) (1992) Habermas and the Public Sphere. Cambridge MA: MIT Press. Cunningham, F. (1994) “Democratic-socialist continua: good and bad”, in Cunningham, F. (ed.) The Real World of Democracy Revisited. Atlantic Highlands NJ: Hummanities Press, pp. 33–50. Dryzek, J. (1994) Discursive Democracy. Cambridge: Cambridge University Press. Dyrberg, T. (1997) The Circular Structure of Power. London: Verso. Foucault, M. (1990) Power/Knowledge: Selected Interviews and Other Writings 1972–1974. New York: Pantheon. Geras, N. (1987) “Post-Marxism?”, New Left Review, 163, pp. 40–82. Habermas, J. (1984) The Theory of Communicative Action, Vol. 1. Cambridge MA: MIT Press. Habermas, J. (1988) The Theory of Communicative Action, Vol. 2. Cambridge: Polity Press. Habermas, J. (1990) Moral Consciousness and Communicative Action. Cambridge MA: MIT Press. Habermas, J. (1991) Communication and the Evolution of Society. Cambridge: Polity Press. Habermas, J. (1995) Justification and Application. Cambridge: Polity Press. Habermas, J. (1996) Between Facts and Norms. Cambridge: Polity Press. Hirschman, A. (1970) Exit, Voice and Loyalty. Cambridge MA: Harvard Universtiy Press. Ingram, D. (1995) Reason, History and Politics. New York: SUNY. Laclau, E. and Mouffe, C. (1985) Hegemony and Socialist Strategy. London: Verso. Laclau, E. and Mouffe, C. (1987) “Post-Marxism without apologies”, New Left Review, 166, pp. 79–106. McCarthy, T. (1994) “Rejoinder to David Hoy”, in Hoy, D. and McCarthy, T. (eds) Critical Theory. Oxford: Blackwell. Meehan, J. (ed.) (1995) Feminists Read Habermas: Gendering the Subject of Discourse. London: Routledge. Mouffe, C. (1992) “Preface: democratic politics today”, in Mouffe, C. (ed.) Dimensions of Radical Democracy. London: Verso. Neocleous, M. (1996) “Friend or enemy? Reading Schmitt politically”, Radical Philosophy, 79, pp. 13–23. Offe, C. and Preuss, U. (1990) “Democratic institutions and moral resources”, in Held, D. (ed.) Modern Political Theory. Cambridge: Polity Press. Outhwaite, W. (1994) Habermas. Cambridge: Polity Press. Ray, L. (1993) Rethinking Critical Theory. London: Sage.

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Schlosberg, D. (1995) “Communicative action in practice: intersubjectivity and new social movements”, Political Studies, 43, 2, pp. 291–311. Self, P. (1993) Government by the Market? The Politics of Public Choice. Basingstoke: Macmillan. Torfing, J. (1997) New Theories of Discourse. Oxford: Blackwell. Townsend, J. (1996) The Politics of Marxism: Critical Debates. London: Leicester University Press. Tullock, G. (1994) “The economic theory of bureaucracy”, in Hill, M. (ed.) The Policy Process: A Reader. Hemel Hempstead: Harvester Wheatsheaf. Walzer, M. (1986) “The politics of Michel Foucault”, in Hoy, D. (ed.) Politics and Social Theory. London: Routledge. Warnke, G. (1992) Justice and Interpretation. Cambridge: Polity Press. Young, I. (1990) Justice and the Politics of Difference. Princeton NJ: Princeton University Press.

CHAPTER THREE Beyond Nimbyism: Urban Conflict Resolution in Swiss Drug Policies1 Daniel Kübler

Introduction Compared with many other European countries, drug policy in Switzerland is relatively liberal. The so-called four-pillar model, implemented by national and local governments since the mid-1980s, places equal importance on prevention of drug use, police action against illegal drug trafficking, therapy for drug users and harm reduction. Harm reduction facilities include syringe exchange schemes, which seek to reduce the risk of contamination with AIDS and hepatitis; injection rooms, where it is possible to inject drugs in hygienic conditions; emergency shelters and drop-ins, where homeless drug users can spend the night; as well as methadone maintenance treatments and, since November 1993, heroin maintenance treatments. Yet, while it is possible to talk about there being a substantial ethical consensus in support of the concept of harm reduction, the policy measures which have been aimed at harm reduction have encountered some significant problems with respect to their implementation. Harm reduction facilities have in general been implemented as urban services, i.e. centres where drug users drop by on a more or less regular basis. These centres have often faced opposition from the neighbourhoods in which they are to be located, many of which claim that harm reduction facilities attract drug users, drug-related crime and prostitution, besides generally impairing the neighbourhood’s standard of living. In several Swiss cities, referendums supported by neighbourhood groups have led to harm reduction services being forced to close down. Cases are multiplying where political lobbying, lawsuits as well as direct (and sometimes violent) action by neighbourhood communities have made the siting of health and social services for drug users extremely difficult. Today, handling such locational conflicts has become a major challenge for those charged with implementing harm reduction policies in Switzerland (Malatesta et al. 1993). This chapter traces out several paths of opposition and accommodation before going on to examine how one community was able to establish a more open, flexible and long-lasting mechanism for dialogue between government and citizens.2 In doing so, I hope to offer others who are working in such contested areas of urban policy one

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vision of community voice which avoids many of the pitfalls commonly associated with what is often known as nimbyism. Before going on to examine these new forms of neighbourhood participation, I briefly set out the context of these locational conflicts. I then consider how participative procedures have emerged to settle locational conflicts and how their emergence fits into the local environment of policy implementation. I have focused on their emergence within the local political structure when viewed as a context for community protest. The final section of this chapter deals with the consequences and effects of these participative procedures. So, with respect to how far we conceive of locational conflicts as genuinely political processes, I explore the ways that new procedures of participation change the rules of the socio-political debate. In particular, I evalvate the democratic quality of these changes. More than Just Nimbyism? Theoretical Preliminaries Conflicts about the implementation of unwanted local facilities are by no means unique to the case of harm reduction facilities for drug users. Instances of community resistance are apparent in areas ranging from provision for the homeless, the mentally ill and people with AIDS (Dear 1992) to technological or public infrastructure investments such as hazardous waste facilities, nuclear power plants, motorways and airports (Allison 1986). Nimbyism in this sense can be defined as “an attitude which is in itself contradictory, in so far as people consider the installation of a certain facility desirable, as long as this is not near to where they live” (Fischer 1993:458; my translation). A large number of studies have examined nimby phenomena3 with many seeking to give “advice on how to quash, moderate, co-opt or appease nimby forces” (Piller 1991: x). This view is underpinned by the premise that local communities are not acting in the common interest. The counter to this is that the general interest could equally be met by the abandonment of a public investment project, e.g. massive urban renewal (Rüegg et al. 1985) or a nuclear waste disposal site (Wälti 1993; Lascoumes 1994). Local protest against the siting of unwanted facilities, then, is not simply caused by selfishness, egoism or ignorance. Although these factors can and do have an impact, contesting the siting of a certain facility can equally mean contesting an official version of the common interest.4 Hence local community resistance against public facilities represents a potential leverage for effectively contesting public policy principles. Locational conflicts are thus genuinely political. They are grounded in value conflicts as well as on differences in the perception and evaluation of potential risks and threats posed by the presence of a facility. In the case of harm reduction facilities for drug users, community resistance is mostly motivated by a concern for the standard of living in a neighbourhood. Communities fear that harm reduction facilities draw drug users into the

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neighbourhood, which in turn leads to crime, begging, prostitution and other unpleasant side effects that common sense associates with drug use. In most cases, community opposition is led by shop owners, restaurateurs, landlords, real-estate developers and the like, to whom the image of a neighbourhood is a crucial economic factor. But conflicts on values and perceptions can only explain the genesis of a community opposition to a certain facility. Independent of this, the incidence and the intensity of community protest will vary with respect to the wider political environment, in the sense that the wider political environment represents a structure of political opportunities within a community. The political opportunity structure of a community, a concept first used by Eisinger (1973), explains protest behaviour by the degree of openness in a political system, defined as permeability of decision-making procedures. Siting conflicts can then be seen as existing where the input dimension of a political system is relatively closed but the output dimension shows signs of openness. The decision to create a facility is taken without significant regard to local interests. But open implementation procedures provide possible routes of intervention for local communities, thereby forcing policy-makers to offer concessions or changes, and generally they increase the likelihood of protest. According to Kitschelt (1986), protest impact can be procedural (i.e. opening new channels of participation to protest actors and involving them as legitimate representatives of local interests), substantive (i.e. changes of policy in response to protest) and structural (i.e. a transformation of the political opportunity structure itself as a consequence of protest activity). The case study shows that community protest against the siting of harm reduction facilities has had all three impacts: procedural, substantive and structural (Kübler et al. 1997). But here I will concentrate on the procedural impact and examine how participative procedures have been developed in response to community protest. In order to do this it is important to understand the structure of political opportunities, part of the earlier theoretical considerations, when investigating new procedures for community participation to resolve locational conflicts. New Procedures of Public Involvement in Locational Disputes A cross-case overview shows that two types of neighbourhood involvement have been set up in Switzerland to handle community opposition against the installation of harm reduction facilities for drug users. The first type consists of ad hoc public meetings where neighbours are informed about the imminent installation of a harm reduction facility, and the second type relates to mechanisms for neighbourhood feedback once the facility has started to function.

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The Public Meeting In all the investigated cases, public meetings were organized for residents and business representatives in neighbourhoods where a future harm reduction facility was to be installed. In each case meetings were very well attended and emotions ran high, as residents expressed their fears and opposition to what at this stage was largely the unknown. Public officials, asked if they had experienced neighbourhood opposition, spoke with one voice: Always. Systematically. I mean in all the places that we have sought to introduce a facility for drug users, there has been fear and opposition, although the way in which this opposition was formulated and formalized varied from case to case. (Social worker, Bern)5 During the first public information assembly, we encountered harsh criticism. (Social worker, Schaffhouse) From the viewpoint of the policy-makers, these public assemblies presented the first opportunity to persuade the neighbourhood of the value of the harm reduction policy, and hence the need to install a particular facility. In ad hoc public meetings, communities are usually told about the functioning of the facility and given the reasons why it should be placed in their particular neighbourhood. In itself, holding the assembly can be seen as an element of the persuasion process, in that policy-makers can show they are taking the fears of the community seriously and they do not want to steamroller a project through at any price. For the policy-makers, the essence of these public meetings is in the first instance to know who the opposition is and what its arguments are. The strategic objective is to handle the opposition, to convince the enemy: The advantage is…if you announce it publicly, you’ll evidently get all the opposition. And then you can try to handle this opposition. (Social worker, Bern) The necessity of handling the opposition is a consequence of the policy-makers’ incapacity to impose the service against a neighbourhood’s will. This incapacity is due to the openness of the decision-making process, which results in a weakness of position for the policy-makers. The political opportunities of an open decision-making process confer on protesters an important potential for obstruction. For direct democratic decision making in Switzerland, the capacity to formulate and implement public policies can considerably depend on the capacity to avoid referendums; or if referendums take place, on the capacity to gain sufficient citizen support to win them. This is true for the harm reduction policy, where community protesters have successfully used the referendum

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weapon on several occasions to halt the implementation of harm reduction facilities. Besides referendums, public inquiries provide another important opening in the political system for community protest. Procedures of building law prescribe that building permits are only granted with the consent of those who are potentially concerned by a new building or by a new use of an old building. Hence building and renovation projects are submitted to public inquiry and neighbours have a formal right of legal appeal. Insofar as the opening of a harm reduction facility often requires a building permit or a renovation permit, the legal procedures of building law represent a powerful means for community protesters to obstruct the implementation of such a facility. They can contest the lawfulness of a building permit in court and unless the courts have judged the plea, construction work is suspended. Although the courts rarely rule in favour of community plaintiffs, litigation often causes considerable delays in the implementation of harm reduction facilities. Hence, from the policy-makers’ point of view, handling the opposition becomes a necessity because direct democratic instruments and the legal procedures of building law give neighbours the ability to obstruct their projects. In the context of such elements of openness in the political opportunity structure, the policy-makers’ capacity to act is highly dependent on their ability to absorb or persuade the opposition: Naturally, we have examined meticulously who had a legitimate right to make a legal appeal. Then we convinced every single one of them not to do so. (Social worker, Schaffhouse) The developing of contacts between policy-makers and communities, then, has to be seen as a strategy of persuasion, which aims to prevent potential obstruction by communities. This idea finds confirmation from community representatives themselves, who often feel that dialogue is only proposed by the policy-makers when they realize that community protest can effectively obstruct the project: [Policy-makers] just planned their project on their own and presented us with a fait acompli. They only began to open a dialogue when we put a spoke in their wheels and they had to realize that they couldn’t do without us. (Neighbour, Zurich) But community opposition is not always peacefully expressed within the institutional rules of the game. Extra-institutional protest against harm reduction facilities for drug users has also occurred, and in most cases this has contained an inherent potential for violence. In 1990, for instance, Basel city government’s plans to implement a mobile needle exchange bus in an inner-city neighbourhood, close to the then existing open drug scene, was successfully obstructed by hundreds of people from the local neighbourhood. They stood in

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the street, blocked the way of the bus on the first day it arrived and threatened staff working on the bus with physical violence. Moving the bus to another location in the same neighbourhood did little to calm community anger: one evening, a social worker who had been working in the bus was beaten up by a group of local residents. Within a fortnight the city government decided to abandon the project. In general, it appears that the capacity of a neighbourhood community to express, formulate and materialize opposition, whether expressed institutionally or extra-institutionally, is a function of its organizational resources of mobilization. In this respect, the communities where protest against harm reduction facilities has occurred cannot be viewed as having started from scratch. Indeed, socio-political activities in those neighbourhood communities are structured by a multiplicity of grass-roots movements, residents and tenants associations and the like. This is especially the case in the larger cities of German-speaking Switzerland, where movements and associations at the neighbourhood level have gained considerable influence in the local political life (Huissoud and Joye 1991). Neighbourhood communities should therefore be considered as structured by networks of associative interest organizations, networks that can be mobilized to protest against public policy initiatives. Where there is an open political opportunity structure alongside neighbourhood communities which have the appropriate organizational resources for mobilizing protest, wide consent and support is particularly important for the policy-makers’ “power of social production” (Stoker 1995:55). Procedures for community involvement can play an important role in gaining support and consent for the planned implementation of harm reduction facilities. The strategy of holding public meetings before the opening of harm reduction facilities has emerged in the context of neighbourhoods which have had the resources to block those projects effectively, and it aims primarily at gaining the support of the community through persuasion. Although these meetings do seek to involve the community as a whole and although they do have the trappings of an open discourse, their structure and method appear to push both the community and to some extent the policymakers themselves towards the adoption of a defensive and particularistic stance. In general, communities are rarely dissuaded from protesting against harm reduction facilities by public meetings, and policy-makers are then left with little option but to involve the community in the implementation process, in the hope it might appease their concerns. Involving the Community in the Implementation Process A fear often voiced by neighbourhood communities is that once a facility has been installed, they will have little or no say over what happens within it. In the Swiss case a number of policy-makers proposed meeting on a regular basis with neighbours, in order to monitor problems that occurred during the time the

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facility was operational. If problems arose, e.g. syringes scattered about, concentrations of drug users in the surroundings, the facility staff would be made aware of this and would then be able to take suitable action to contain the problems. Such confidence-boosting measures helped to calm down community protest in a significant number of cases.6 Neighbourhood feedback mechanisms have taken different forms: phone numbers given to neighbours where they can complain in case of problems, regular public meetings, or neighbourhood observation groups where problems could be discussed with facility staff on a regular basis. But in all cases the rationale is always to gain community support by demonstrating that fears and apprehensions have not been ignored and are in fact taken seriously: I think it is important that neighbours have an occasion where they can express their complaints. If it needs to be a neighbourhoodmeeting or a commission, I am not sure. I think we must take neighbours’ fears seriously and we must try to solve problems effectively. I mean [the government] is also interested in having conditions in which drug users are not stigmatized too much. If this needs to be a neighbourhood commission, regular meetings or just a phone number where neighbours can call, then fine. What is important to me is that if there is a problem, we react immediately, so that the problems and bad feelings that go along with them don’t pile up and become so big that a rational debate is no longer possible. (Government representative, Bern) For facility staff, regular feedback from the neighbours is seen as an opportunity to take the temperature in the community. If any problems appear, they demonstratively take suitable action, in order to keep acceptance of the facility high. We want to demonstrate an openness towards problems that are caused by our facilities in the neighbourhood. People can come to see us and complain…. We always point out that the tour through the neighbourhood that we do every two days in order to pick up scattered syringes can only be effective if neighbours support us by telling us the places where particular quantities of syringes are…. I don’t think that it is a question of whether we can really solve every problem. It’s more important that neighbours can see that we are not ignoring their fears and that we are trying to do something about them, and afterwards, ask whether the situation has improved or not. (Social worker, Basel) But why is there a need to gain acceptance in exchange for participation and why are the traditional political legitimation procedures not capable of building such trust? Why does the community not believe that policy-makers will hold to their promises when they say that they will do whatever is possible to avoid the

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negative externalities of a harm reduction facility? This seems to be a phenomenon that relates to the general theme of mistrust towards political elites and public administrators. In interviews with neighbours, we found that policymakers and implementers have had a bad reputation in the field of drug policy, and they were continuously being accused of having broken promises and having colluded with minority interests: [The public] want public money to be spent in a coordinated way on drug policies, i.e. we don’t want associations to be financed whose methods or aims are contrary to the official drug policy principles. That was the case with ZAGJP [an NGO that projected a boarding house in Zurich which was successfully blocked by neighbours]…. By the way, when the owner of the house where the shelter was to be installed, refused to sell it, it was occupied by a group of squatters. We can’t prove that, but there was certainly some link [between the ZAGJP and the group of squatters]. (Neighbour, Zurich) This implies that we need to take a closer look at who those policy-makers are. In other words, we need to examine the actors and institutions working in the drug policy network.7 There can be little doubt that the most important feature of drug policy at the local level in Switzerland is that the majority of programmes are implemented by non-governmental organizations (NGOs), which in turn are subsidized by public funds (Malatesta et al. 1992). These partnerships appear as a means of coordinating a complex framework of institutional responsibilities. Switzerland is a federal state, where in each policy field there exists a constitutionally defined partition of competence between the cantons and the central state. In relation to public health matters, cantons have primary competence and the central state can only decree direct measures in the case of epidemics. Moreover, with respect to policy for socially marginalized individuals, most cantons have delegated responsibility to municipalities. But since drug policy relates to public health and social policy, and the AIDS aspect is dealt with as an epidemic, all three levels of the state have a vested interest in drug policy: communes for social action, cantons for aspects of public health, and the central state on controlling the spread of an epidemic. Such a complicated set of accountabilities could easily produce a muddle of actions and actors, so cooperation is therefore important. A common form of cooperational agreement is to delegate control to NGOs which are financed by all three levels of the state; these NGOs then conduct and implement an agreed policy (Bütschi and Cattacin 1994). The NGO option was also partly a consequence of the fact that when, during the 1980s, both national and local authorities wanted to undertake direct action in favour of drug users, they came up against a knowledge problem. It quickly became apparent that the knowledge of how to work with a group living with stigmatization and illegality, such as drug users, lay largely with charitable

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organizations or militant youth associations who had, in the past, been taking care of drug users on a voluntary basis. Delegating policy imple mentation to NGOs such as these therefore appears to present the most efficient use of existing know-how. Drug policy in Switzerland has largely taken place within the context of what may be termed an enabling state, i.e. a model of public policy implementation where the state decress general rules and priorities of action that are carried out by non-state actors. Such a pattern of policy implementation has a number of important implications for the process of decision making and the role of the traditional democratic political institutions. Given that subsidized contracts with NGOs are the major instrument of the enabling state, the executive and public administrators who manage them are placed in an important position. Legislatures can only ratify financial decrees that roughly set out an order of priorities, but cannot define the substantive content of the projects and actions carried out by the enabled NGOs. This shift of power away from legislatures is sometimes part of a deliberate strategy by government officials and NGO representatives, hoping to avoid what they call problems of populism introduced by eventual ideological polarization of drug policy issues in parliamentary or electoral debates (Kübler 1993). However, this restriction of the public sphere can also be seen to affect traditional legitimation procedures. In the view of Jürgen Habermas, the enabling state appears as a public policy model that uncouples the policy process from the democratic procedures of decision making, since policy goals are no longer defined through public debate but rather in behind the scenes negotiations between government, public administrators and the enabled implementing agencies (Habermas 1992:389). Traditional instances of participation (parliamentary debate, public debate) appear to be somewhat in retreat in this context. In the enabling state, the legitimacy of policy is not primarily created through public debate and democratic decision making, but is argued to emerge from the effectiveness of efficient implementation itself. In the context of harm reduction facilities for drug users in Switzerland, this means the question of legitimacy and trustworthiness of the implementing agencies is not regulated through public political debate or democratic participation. From the community’s perspective, the trustworthiness of an enabled private policy implementer is built upon the relationship the community establishes with the implementer. Thus, if there is a need to build up trust with private policy implementers, it is necessary to imagine systems other than the traditional channels of participation, since they do not provide sufficient regulation of the relationship between enabled agencies and the citizen. Even the most distrustful of neighbours often find it beneficial to have feedback mechanisms with titles such as the neighbourhood commission, especially when government representatives are involved: You know, in groups large as this [neighbourhood commission], there are always a number of distinct opinions. But the Social Department and the

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Police Department were also part of it, so we knew who to contact in case we wanted to complain. The only advantage I see with such a body is that you get to know each other and you also get to know the channels for complaints and how you can get to them in an unbureaucratic and easy way without it being necessary to write long letters that won’t be answered anyway. The main point of this body would have been that in case of a problem with the facility, you could just pick up the phone and quickly get in touch with an appropriate member of the government. (Neighbour, Zurich) Thus, neighbourhood commissions, regular meetings and other systems of neighbourhood feedback can help to ensure that neighbours really do have the opportunity to affect the implementation and management of a harm reduction facility. Neighbourhood feedback mechanisms can be seen as an important means of creating community support through participation, especially in the context of a pattern of policy implementation where enabled agencies cannot directly draw upon an official legitimacy. These mechanisms of neighbourhood feedback are organized as collective bodies. However, they appear to operate most effectively when seeking to address and, where appropriate, rectify problems brought up by individuals or groups of individuals. Reacting on a complaint-by-complaint basis, neighbours aim to minimize the negative externalities that a harm reduction facility may cause, and public officials can seek to ensure the implementation of their policies. Neighbourhood Participation and the Public Sphere The last section tried to show that the emergence of new forms of neighbourhood participation can best be understood as a strategy for absorbing community protest. In a political opportunity structure which allows community opposition an effective means to obstruct the implementation of such facilities, their engagement offers a means of achieving successful implementation. In the development of harm reduction facilities in Switzerland, successful implementation has involved community-initiated change. To the extent that mechanisms of community feedback involve citizens in defining and managing the activities of harm reduction facilities, they have allowed the introduction of the neighbour’s viewpoint. In this respect, such mechanisms can be considered as a form of democratic policy-making in that they enable the development of a potential sphere of public debate in the sense put forward by Jürgen Habermas (1990); he refers to a debate where arguments concerning political choices are able to compete without limitation and in a transparent way. Nevertheless, our research evidence suggests that policy-makers attempt to instrumentalize the procedures of participation, and this can seriously threaten their functioning and meaning. In his work on the public sphere, Habermas

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suggests that a public sphere is always submitted to the tension of “refeudalization” (Habermas 1990:337). Habermas argues that having estab lished a public sphere as a place of rational dialogue where one can seek to establish a widely acceptable solution to a problem, there is a tendency for actors to instrumentalize and colonize this public sphere according to their own interests. They can do this by manipulating the agenda or imposing a certain style of discussion or debate. Attempts to intrumentalize the newly created forms of neighbourhood participation were evident from our research programme. In one example it was apparent that policy-makers had the deliberate aim of restricting the themes of discussion at neighbourhood meetings, in order to avoid potentially uncomfortable debate: During one period, we invited government representatives into the organizing committee [of a neighbourhood forum]. But when at the next forum the organizing committee decided that certain issues should be discussed, a number of the government representatives said that this would disturb their planning process. We realized that we were getting paralyzed and that the forum must be able to discuss freely and in a critical way. (Social worker, Basel) In some cases, neighbours believed that their point of view had lost out to a plethora of alternative views: The neighbours felt that this neighbourhood commission has changed into a place of organized interests of drug users and their social workers. (Neighbour, Basel) Many community participants also found the structure and procedures that had been introduced to these community mechanisms by the public officials to be quite alienating. Articulating one’s complaints in a large meeting requires certain social skills and resources. This starts with language and ends with rhetoric. It requires a good deal of courage and a sound discourse to stand up and argue against the points put forward by facility staff in particular. Actually, it is possible to talk to [facility staff]. But they always have counter-arguments. They always say “yes, but”, I don’t see any “but”. Yet I have to face the consequences of the facility the whole day long. I stop arguing; it’s like talking to a wall I think they should contact neighbours personally and say, “Look, lets talk about it”. But they don’t do it. At best, there is one [social worker] who stands outside saying, “Come over Mrs X, talk to us if you have any problems”. Why don’t they come and talk to us? They should contact people and talk one-to-one, rather than solely organizing discussions in groups What is the point in me going to such

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group discussions? There is really no point at all. One says this, another one says that. (Neighbour, Schaffhouse) In the case of neighbourhood meetings organized periodically by facility staff, there was an apparent tendency for them to be used for a staging of the positive aspects of a facility. If the debates are no longer controversial because they are excluding a certain viewpoint, neighbours quickly find them boring and consequently withdraw, believing them to be a waste of their time: At this meeting, they informed us how many drug users come to the facility per day, how many syringes they distribute per month and per year. I felt that I didn’t need to go to these meetings any more. I can read the same information in the newspaper. I have other things to do. They always tell you the same stuff. (Neighbour, Schaffhouse) Another problem in relation to neighbourhood participation is the information gap. Given that they work in the drug field all day long, policy-makers and facility staff are much better informed on events and processes and, in consequence, have a greater stock of good arguments to use in discussion, as well as greater experience of discussing drug policy issues. This results in them occupying a central position in the discussion and debate: [One of the government representatives] speaks extremely well. You can see that he has a lot of experience of speaking about such matters; one could even view much of it to be prefabricated slogans…. The central role [he] plays in the whole debate is striking. He gives hints to the chairman if he wants to or if he doesn’t want to say something about an issue, and makes it clear who in the public could give a competent response. And when he speaks, one can notice the enormous information gap that separates him from the rest of the audience. He is an authority, even if he doesn’t consciously want to be. However, sometimes he takes advantage of this fact, especially when there is a need to clarify a political opinion or to cut short a discussion. (Observation report of a neighbourhood commission, Basel) These tensions were evident in all the empirical examples that were evaluated. So given these problems, how best can the threat of colonization be minimized? This is the topic of the next section. The Basel Drogenstammtisch: An Example of a New Public Sphere The neighbourhood participation system set up in the Swiss city of Basel probably provides the best example of where a genuine public sphere of debate has

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emerged and been affirmed. Centred on community involvement in the management of harm reduction facilities for drug users, it has been termed the Drogenstammtisch.8 The Drogenstammtisch was created in January 1991, without any of the participants knowing that this peculiar system of neighbourhood participation would later become a major focus for public debate on drug policy in Basel.9 In the beginning, the sole idea was to solve a violent conflict between social workers and residents that had developed in the inner-city area of Kleinbasel. Residents had become fed up with the concentrated presence of drug users and dealers, as well as the externalities of harm reduction facilities in their neighbourhood (noise, dirt, used syringes scattered all about, etc.). It is no exaggeration to say, at the time, the local community was at war with the social workers responsible for health care and AIDS prevention for drug users. Yet the political opportunity structure did not provide any lever for community protest, since all the harm reduction facilities in this particular neighbourhood were the responsibility of a charitable body who ran them without state funding. The situation was exacerbated when the city government attempted to introduce a mobile syringe exchange scheme. Given that legal appeals and institutional opposition were not possible in this case either, the project was blocked by violent community action as I outlined earlier. Shortly afterwards a group of people from a centre of alternative culture in the neighbourhood came up with the idea of holding a Drogenstammtisch. The concept of a stammtisch has a long history among German-speaking peoples, most notably in southern Germany and the German-speaking cantons of Switzerland. Although now largely associated with German drinking culture, the term “stammtisch” is significant because it refers to a mechanism which stands outside the state and where informal discussion and debate are made possible. In the case of the Drogenstammtisch, this involved round-table talks with all the protagonists present, in order to establish what, if anything, could be done about the embittered climate that had developed in the neighbourhood. It has to be said that, at the time, none of the protagonists involved considered an exit option to be viable.10 The social workers were not willing to close down the facilities for drug users, for whom they felt responsible, and the neighbours preferred to protest rather than to move away. As such, these first round-table talks were presented as a kind of safety valve, there to prevent further violent clashes in the neighbourhood. For both sides, social workers and residents, the meeting presented an opportunity to talk peace, or at least to cease hostilities, in a situation where the adversaries were equally powerful and equally unwilling to give ground. To avoid giving any sense of advantage to either side, a number of rules of the game were defined by the organizers of these first round-table talks. The principle of equal treatment was indeed posed as a precondition by the participants.

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We organized a first meeting and distributed leaflets with invitations. We said that this is an intimate discussion, no newspapers, no politicians, only people from this neighbourhood. A discussion between neighbours, business tenants and junkies…fifty people came. That’s a lot. All the protagonists were there. Two people from the cultural centre chaired the meeting—it was clear that I couldn’t have done that (I also kept very much to myself in the discussion). In this case “chair the meeting” meant that everyone was allowed to speak and that contributions were limited in order to ensure that this was possible. (Social worker, Basel) Thus, from its beginning, the Drogenstammtisch had no formal decisionmaking power and it still has not. Its rationale was simply to provide a forum for debate in an embroiled neighbourhood, with the hope that something would happen. What happened was that the first meetings resulted in a general relief of tension between social workers and neighbours. We nearly spat at each other at this first [Drogenstammtisch]. But in the end, we started to listen to each other. At a certain point I said, “I think it is our moral duty to care about our own drug users, but we do not want to be a reservoir for drug users coming from the whole region”…. Then something happened. Suddenly, there was no more squabbling; we listened to each other and realized: dammit, in some way, we all want the same thing. We [neighbours] want peace in the neighbourhood but we also realize that drug users are human beings. You [social workers] want to help them but also need to live with us. (Neighbour, Basel) Jointly, neighbours and social workers came together to devise a strategy to decentralize the harm reduction facilities. The Drogenstammtisch became somewhat more formalized with the foundation of a so-called action committee, a board composed of neighbours and social workers. The action committee had the task of lobbying in favour of the Drogenstammtisch’s policy aim, which was to reduce the presence of drug users in Kleinbasel by creating harm reduction facilities in other parts of the city. The action committee regularly organized meetings of the Drogenstammtisch where further measures were discussed. One striking example was where the Drogenstammtisch initiated the setting up of a street-corner agency for drug users in a residential neighbourhood under cover of night. This facility, which was totally illegal, was in fact paid for by business tenants participating in the Drogenstammtisch. This development caused the Drogenstammtisch enormous problems with the city government and with the residential neighbourhood community, yet it still represented an important move towards the decentralization of harm reduction facilities for drug users. It also demonstrated that the Drogenstammtisch could not itself be accused of simple nimbyism, because while it wished to see a decentralization of harm reduction facilities across the city, it accepted that some of those facilities should be

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located in Kleinbasel itself. Thus, while it had no formal power to make decisions, the Drogenstammtisch had a major impact in putting a new claim onto the policy agenda—the decentralization of harm reduction facilities. At the same time, this policy represented an acceptable compromise in the conflict between city residents rallying to close down the harm reduction facilities and social workers lobbying to create more of them. In June 1991 the city government opened the first entirely state-financed street-corner agency, outside Kleinbasel. Two more followed in February and September 1992, and since then health care for drug users in Basel has been provided through a network of harm reduction facilities which cover the whole city. In parallel, the concentration of drug users in the neighbourhood of Kleinbasel started to decrease. The rate of reduction was then increased when, in early 1994, police patrols in the area started to take action against drug use in public places. The action committee has continued to organize regular meetings of the Drogenstammtisch. At the time of writing, there were monthly meetings except for a summer break. The topics discussed at the Drogenstammtisch have changed and expanded. They are no longer limited to Kleinbasel or the issue of harm reduction facilities. Today the Drogenstammtisch is a forum for debate on drug policy measures in Basel as a whole. The value of the Drogenstammtisch has begun to be recognized by the general community, and it is now respected as a place where the community can discuss their preoccupations and opinions concerning drug policy measures with social workers, representatives of the government and drug users. Debate at the Drogenstammtisch is open and, according to the participants, divergent opinions are respected and discussed rationally. Moreover, because the action committee appears able to select issues which the community finds topical, meetings of the Drogenstammtisch are usually well attended. The Drogenstammtisch is thus an important place where public debate about drug policy measures in Basel is shaped. Of particular importance is the fact that, despite the absence of any formal decision-making power, it has established for itself an important role in Basel’s drug policy-making process. For the government and its enabled NGO partners, the debate at the Drogenstammtisch is a valuable barometer of public sentiment. It is also a valuable source of information with respect to new problems, or needs that require new policy measures or the reorientation of old ones. The openness of debate at the Drogenstammtisch is a determining factor in it being viewed as a legitimate source of input into the policy process. The Drogenstammtisch plays an important role in determining Basel drug policy…. The Drogenstammtisch is like a democratic forum of control, debate and input. Firstly, it is all private: the action committee decides the topics and the frequency of discussion but it always collaborates with the government. Thanks to that, the Drogenstammtisch is always up to date.

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Government representatives participate voluntarily and are happy to do so. The debate is totally free and critical opinions are ever present. Basel’s Junkie Association also participates. Thus, there is a guarantee that no argument is lost. At the Drogenstammtisch we can always have a look at what other people think about what we are doing, what critical people think about it and where problems are. It’s really great! It’s like a place of contact between those who are concerned about our activities and the public administration side of things and it is also a place of contact for those who are concerned for themselves. (Government representative, Basel) The Drogenstammtisch in the Wider Context What makes the Drogenstammtisch peculiar as a forum producing inputs into the policy process, is the fact that these inputs are grounded in what Habermas has termed “communicative rationality” (Habermas 1981). And albeit on a temporary basis, these policy inputs represent consensuses on value orientations that competent actors have reached through discussions oriented towards intersubjective understanding, that is “free from deception, selfdeception, strategic behaviour, and domination through the exercise of power” (Dryzek 1994:14). Consequently, the Drogenstammtisch can be seen as adding an important democratic quality to the decision-making process. However, this communicative quality of the Drogenstammtisch depends very much on the absence of the strategies of instrumentalization that have been considered in this chapter. Somewhat ironically the background to establishing the Drogenstammtisch, with its high level of conflict, was probably a warranty against colonization by any one actor. In such a conflictual situation, dialogue was only considered possible when all actors believed they could express themselves freely and in doing so would not be compromised into accepting something they did not want. When the Drogenstammtisch was first established, the original conflict was still latently present and actors could still threaten to leave and engage in a single-actor strategy if they considered the rules of the game were not being respected any more.11 Coming into existence as an alternative to open conflict, the Drogenstammtisch of Basel was held together by the continuous threat of falling back into the conflictual situation that existed beforehand, and nobody wanted that. Latent conflict was present throughout the life of the Drogenstammtisch. Neighbours were as organized as the social workers. It seems that the Drogenstammtisch is one piece in a general mosaic of actor constellation within the field of Basel’s drug policy: What I wanted to say is that the Drogenstammtisch is actually praised as an ideal example which everyone should follow…. Well certainly it had an important role, but it’s not the only thing. There is a feeling that thanks to

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the Drogenstammtisch, the situation is quite good here. I would say that the situation is good because of the Drogenstammtisch and its counterweight the Neighbourhood Association…. It would be wrong to say that it is all down to the Drogenstammtisch. Certainly it played an important role, but other things have played an important role as well. (Neighbour, Basel) Without the Drogenstammtisch, the whole mosaic would be lacking a piece; but without the rest, the Drogenstammtisch couldn’t assume its role of integrating the different actors into a collective dialogue. The success of Basel’s Drogenstammtisch to resist attempts at colonization lies in the fact that it was never viewed as a means of suppressing conflict, but always as a means of channelling conflict into a civilized discussion. Conclusion: New Forms of Participation and New Systems for Policy Acceptance In the case of locational conflicts concerning harm reduction facilities for drug users in Switzerland, three forms of neighbourhood involvement have emerged: ad hoc public assemblies, mechanisms of neighbourhood feedback, and the Drogenstammtisch or public forum. The holding of ad hoc public assemblies seems to function on a rationale of a passive, audience-like role for the community. In most cities, however, the holding of these assemblies led to the development of more elaborate mechanisms for community feedback; and they can be viewed as mechanisms for citizen participation, in the sense that they have involved the community in the implementation process of harm reduction facilities. And the Drogenstammtisch that was established in Basel is an example of a forum where citizen participation was realized through the process of public debate. The determining factor which separates the Drogenstammtisch from the other two mechanisms for community feedback discussed is the autonomy of the body itself from state structures, and the open structure for debate that has been established within it. Although the other forms of community feedback may be collectivist, they are also more likely to be particularistic, in that participants are more likely to adopt defensive positions rather then listen to an open debate of all the issues. We have also seen that the emergence of different forms of community participation is tightly linked to the particularities of locational conflicts. In this context, it seems possible to argue that new forms of community participation have only emerged in situations where the political opportunity structure pushes towards a trade-off between policy-makers and neighbourhood communities— participation in exchange for community support. Community support is required for successful policy implementation. It is therefore essential to understand how the local context makes this trade-off necessary, for this will directly shape the rationale and probably the design of new forms of community participation. In that respect, the Basel case seems to be rather unusual. The Drogenstammtisch

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emerged in the midst of a very conflictual situation, where the community and social workers were at loggerheads while the government was not present as a major player in its own right. This meant that a trade off could only be established at a grass-roots level, between the neighbourhood community and the social workers. In other cities, conflict has occurred at a different level with the consequent involvement of government bodies. But be that as it may, one further question remains to be answered. When new forms of community participation show themselves able to create community support for harm reduction facilities and in doing so to appease locational conflicts, how is this actually achieved? In other words, what is it about the new forms of participation that creates acceptance, and why does traditional participation fail to achieve it? According to Habermas (1992), legitimacy, or the acceptance of public policies in a democratic polity, is created through procedures that ensure such policies are the result of deliberation. The more citizens consider public policies through a process of deliberation, the better they accept them. New forms of participation then create acceptance of a policy by increasing the deliberative element in its formulation or in its implementation. This idea can be substantiated by briefly returning to our empirical example. We have seen how the neighbourhood feedback mechanisms and the Drogenstammtisch provided a deliberative context for the community and policy implementers in relation to the management of harm reduction. This potential had not been present with traditional forms of participation such as legal appeals and direct democracy. By its very nature, a legal appeal is not a deliberative process. Once the judge or the jury have come to a decision, no further discussion on the matter is possible.12 This also applies to direct democracy. Neidhart (1970) has shown that direct democratic institutions involve negotiation with citizens and interest groups, but this only takes place before a popular vote. Once the policy has been approved, there is no institutional mechanism for continuing the debate. But with the new forms of neighbourhood participation analyzed above, it is possible to carry on the deliberation during the implementation process. So these new procedures of neighbourhood participation can be seen as increasing the flexibility for citizen intervention in the policy process. I think that is one of the major assets of these mechanisms, especially in a field like drug policy, where consequences of agreed policy measures are difficult to foresee. Another advantage of the new forms of neighbourhood participation can be seen in their potential to provide an answer to the salient issue of democratic legitimacy for network policy-making, where political accountabilities are often difficult to locate. According to Fritz Scharpf (1993), the major challenge for democracy in the context of an enabling state is that participants in policy networks will often have heterogeneous bases of legitimation that are not sufficiently integrated by traditional instances of legitimation. In the context of an enabling state where the implementation structures combine different levels

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of government as well as public-private partnerships, the pertinent space of legitimation becomes a difficult issue. It raises the question as to which is the pertinent citizen aggregation that should be consulted when policy measures implicate the federal level, the cantonal level, the communal level, and last but not least, private associations. The new forms of neighbourhood participation analyzed in this chapter have demonstrated that, in harm reduction policy matters, a pertinent space of legitimation can be territorially defined in the sense of places where the projected policy measures are likely to produce some effect.13 In the extent to which some of the analyzed systems of neighbourhood participation were, in a communicative manner, effectively able to integrate heterogeneous bases of legitimation as well as diverging interests and viewpoints, they provided an example of democratic good practice in the context of an enabling state. However, the nature of participation systems does impose certain limitations. Firstly, they are focused on the area of policy implementation. And by taking this focus, the central issue of policy development is ignored. In the Swiss case study on drug policy, the initial decision to establish harm reduction facilities was not under consideration. Discussion was limited to how, when and where rather than if. One might counter that democratization of the policy process must be viewed as a multifaceted concept, and the new forms of neighbourhood participation merely address a much neglected part of that. But if this view is accepted, the burden still lies with policy-makers and politicians to ensure that similar levels of deliberation are in evidence at other crucial points in the policy process. A related point concerns the policy implementation process itself. In the Swiss case, the nature of drug policy meant there was a built-in level of flexibility in relation to the introduction of harm reduction facilities that allowed for a deliberative outcome which satisfied most if not all participants. However, would this be the case in the establishment of a nuclear power station, where the potential to site the facility in a different location or to minimize externalities may not provide enough scope to allow a deliberative body which has its focus on implementational issues to gain public approval? Finally, one is left asking whether the discussion within the Drogenstammtisch can truly be termed deliberative. Certainly, when judged against the Habermas dictum that deliberative democracy should involve a situation where participants are only prepared to select the best argument, even the Drogenstammtisch cannot fully measure up. But although it may be difficult to establish whether or not consensus equals compromise or the victory of the best suggestion, the arguments are still significant and concern themselves with more than semantics alone. This issue will be revisited in the concluding chapter.

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Notes 1. This chapter is based on a research project financed by the Swiss Federal Office of Public Health, conducted at the Institut de recherche sur l’environnement construit of the Swiss Federal Institute of Technology (Kübler et al. 1997). The present version owes much to the many stimulating discussions with the other authors of this book as well as, in particular, to the editor’s thoughtful and detailed comments. I am also grateful to Dominique Joye, Dominique Malatesta, Dominique Hausser, Yannis Papadopoulos and Margret Rihs for their remarks and criticism on earlier drafts. 2. Empirical evidence is drawn from qualitative case studies of siting conflicts about needle exchange schemes and injection rooms for drug users in six Swiss cities (Basel, Bern, Lucerne, Schaffhausen, St Gallen and Zurich). Data was collected through reviews of the local and national press, direct observation of neighbourhood forums and 51 interviews with government representatives, neighbours, social workers and drug users. 3. Analysis of nimby activism has produced a series of acronyms to qualify variations of the nimby syndrome. “These include NOOS (for not on our street) and LULU (locally unwanted land uses). The spread of NIMBY to the environmental movement has led to the slogan NOPE, for not on planet earth. More cynical observers have been quick to note the connection between citizen’s movements and politicians’ behaviour, and coined the acronym NIMTOO, for not in my term of office. Finally, so ubiquitous are NIMBY sentiments in association with slow-growth and no-growth movements that some observers have noted the rise of CAVE groups citizens against virtually everything” (Dear 1992:289). 4. In this respect, Charles Piller’s (1991) work convincingly demonstrates how nimby activism against technological projects (nuclear weapons manufacturing, environmental release of genetically altered micro-organisms, biomedical research laboratories) is partly a reaction against the quasi-religious faith in science and technology in the United States after the Second World War. Hence, concludes Pillar, nimby activism and its impacts in these domains have effectively defied the American technological optimism as a policy principle. 5. These quotes are drawn from our interviews and have been translated into English. The original language of the interviews is Swiss German dialect. 6. Nevertheless, the project of a boarding house in Zurich is a counter-example. In spite of important efforts in setting up formalized channels of neighbourhood feedback, a small group of hard-line protesters did not retreat from their legal appeal that finally made the project fail. 7. For the concept of policy network see, among others, Wright (1988), Rhodes (1985), Le Galès and Thatcher (1995). 8. The German Drogenstammtisch could be translated as “round-table talks on drugs”. 9. On the history of the Drogenstammtisch see Nabholz-Kartaschoff (1996). 10. This is an interesting and important observation, since the situation is by no means obvious. Eisner (1993) has shown that, in a central city district of Zurich, the deterioration of the standard of living due to the concentrated presence of drug users has resulted in an important “exit” movement of residents (and especially

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families with children) who moved to other districts. The will of the neighbourhood community to “voice” rather than to “exit” (Hirschman 1970) in the Kleinbasel case can be explained by its social structure. A former red-light district, Kleinbasel has been in gentrification since the early 1980s and is nowadays considered as one of the exciting places to live in Basel. Moreover, the traditional and world-famous Basel carnival is mainly rooted in Kleinbasel and has contributed to the vivacity of the neighbourhood’s social scene. 11. The Drogenstammtisch witnessed an important crisis at the end of 1991, when a group of neighbours left to protest against the slowness of removing drug users from the Kleinbasel area. This group then chose to lobby on its own. But in 1995, on the Drogenstammtisch’s fifth anniversary, they joined in again. 12. Nevertheless, threats of lawsuits sometimes produce deliberation between the parties in order to reach an agreement outside the courts. In the cases examined here, this was true for a harm reduction facility in Bern. The appellants agreed to retreat from their appeal, under condition that a neighbourhood feedback mechanism was set up. 13. In this case the systems of neighbourhood dialogue analyzed above completely discount those who paid for the policy measures through taxes. Indeed, in our analysis we did not consider the neighbourhood protests as “taxpayer revolts” (Clark 1995).

References Allison, L. (1986) “On dirty public things”, Political Geography Quarterly, 5, pp. 241–51. Bütschi, D. and Cattacin, S. (1994) Le Modèle Suisse du Bien-être. Lausanne: Réalités sociales. Clark, T. (ed.) (1995) Innovative Strategies for Turbulent Times. London: Sage. Dear, M. (1992) “Understanding and overcoming the nimby syndrome”, Journal of the American Planning Association, 58, pp. 288–300. Dryzek, J. (1994) Discursive Democracy. Cambridge: Cambridge University Press. Eisinger, P. (1973) “The conditions of protest behavior in American cities”, American Political Science Review, 67, pp. 11–28. Eisner, M. (1993) “Städtische Drogenmärkte, Beschaffungsdelikte und die Folgen in den betroffenen Stadtquartieren”, Drogalkohol, 17, pp. 195–208. Fischer, F. (1993) “Bürger, Experten und Politik nach dem ‘Nimby’-prinzip: Ein Plädoyer für die partizipatorische Policy-Analyse”, Politische Vierteljahresschrift, 24, pp. 451–70. Habermas, J. (1981) Theorie des kommunikativen Handelns. Frankfurt: Suhrkamp. Habermas, J. (1990) Strukturwandel der Öffentlichkeit. Frankfurt: Suhrkamp. Habermas, J. (1992) Faktizität und Geltung. Frankfurt: Suhrkamp. Hirschman, A. (1970) Exit, Voice and Loyalty. Cambridge MA: Harvard University Press. Huissoud, T. and Joye, D. (1991) “Participation, insertion locale et démocratie directe dans les espaces urbains”, Annuaire Suisse de Science Politique, 31, pp. 109– 28. Kitschelt, H. (1986) “Political opportunity structures and political protest: anti-nuclear movements in four democracies”, British Journal of Political Science, 16, pp. 57– 85. Kübler, D. (1993) L’état face à la toxicomanie: action publique et contrat social. Lausanne: Institut de science politique.

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Kübler, D., Malatesta, D., Joye, D., Hausser, S. (1997) Entre Santé Publique et Ordre Public: L’Impact dans les Voisinages de Services de Reduction des Risques pour Consommateurs de Drogues en Suisse. Lausanne: IREC-DA/EPFL. Lascoumes, P. (1994) L’Éco-pouvoir: Environnements et Politiques. Paris: Editions La Découverte. Le Galès, P. and Thatcher, M. (1995) Les Réseaux de Politique Publique: Débats sur les Policy Networks. Paris: L’Harmattan. Malatesta, D., Joye, D. et al. (1992) Villes et Toxicomanie: des Politiques Urbaines de la Prevention du Sida en Suisse. Lausanne: IREC-DA/EPFL. Malatesta, D., Kübler, D. et al. (1993) Zone et Quartier: Rapport sur une Étude de Faisabilité Présenté a l’Office Federal de la Santé Publique. Lausanne: IREC-DA/ EPFL. Nabholz-Kartaschoff, M. (1996) Funf Jahre Drogenstammtisch: Ein Beitrag zum sozialen Basel: Basel. Neidhart, L. (1970) Plebiszit und Pluralitäre Demokratie. Bern: Francke. Piller, C. (1991) The Fail-safe Society: Community Defiance and the End of the American Technological Optimism. New York: Basic Books. Rhodes, R. (1985) “Power-dependence, policy communities and intergovernmental networks”, Public Administration Bulletin, 49, pp. 4–29. Rüegg, E., Kleger, H. et al. (1985) “Politik der Verstädterung—Zerfall der Urbanität: vom lebensweltlichen Protest zur demokratischen Öffentlichkeit?”, Annuaire Suisse de Science Politique, 25, pp. 157–82. Scharpf, F. (1993) “Versuch über Demokratie im verhandelnden Staat”, in Czada, R. and Schmidt, M. (eds) Verhandlungsdemokratie, Interessenvermittlung, Regierbarkeit. Opladen: Westdeutscher Verlag, pp. 25–50. Stoker, G. (1995) “Regime theory and urban politics”, in Judge, D., Stoker, G. and Wolman, H. (eds) Theories of Urban Politics. London: Sage, pp. 54–71. Wälti, S. (1993) “Neue Problemlösungsstrategien in der nuklearen Entsorgung”, Annuaire Suisse de Science Politique, 33, pp. 205–24. Wright, M. (1988) “Policy community, policy network and comparative industrial policies”, Political Studies, 36, pp. 593–612.

CHAPTER FOUR Deliberation, Democracy and Opinion Polls: Evaluating the Choice Questionnaire1 Danielle Bütschi

Introduction In 1936 when Gallup invented representative opinion polls, he thought he had found a way to restore the ideal of deliberative democracy, which would allow for the development of a continuous public dialogue about the political issues of the day. In combining modern communication techniques with what he then termed sampling referendums, Gallup (1939) believed he had brought together the conditions necessary to set up town meetings at a national level. Yet the reality of today’s opinion polls appear to lie far from Gallup’s original hopes. The art of polling has been transformed into an art of prediction. Even the most structured sampling techniques cannot be said to generate any real deliberation and in many cases citizens are asked about issues of which they know little and upon which they are given little if any time to reflect. The result is the generation of what have been termed non-attitudes, where people do not have any fixed opinions about a majority of political issues, leading them to put forward largely random ideas (Converse 1964, 1970). When the results of opinion polls that have not been based upon deliberative debate are then relayed via the media, this can become a method for actually forming public opinion and consequently affecting the governmental policy process (Champagne 1990). Besides that, opinion polls which merely comprise an aggregation of individual opinions are often accused of effectively stifling or undermining true public debate (Salmon and Glasser 1995). So what role if any should opinion polls play in a liberal democracy? Well, while today’s opinion polls may not match up to Gallup’s deliberative ideal, they do within their limited operational framework guarantee an equal access to voice. And in liberal democracies where the central aspect of citizenship revolves around the election of political representatives, opinion polls constitute an almost unique occasion for the public as a whole to exert influence on politicians and the policy process. Zukin (1981) puts it like this: Polls transmit (both informed and uninformed) opinion to decision makers via the media. Leader’s actions are fed back to the public via the media,

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and the public’s evaluations of leaders’ actions are recorded by more opinion polls…. By organising the voice of citizens and consumers, polls allow the public to compete in defining the issues (or setting the agenda) that government chooses to deal with. If anything the importance ascribed to opinion polls by politicians is greater now than it has ever been. Taking a lead from North American politics, a number of European countries, including Britain, France and Germany, have over the last decade or so, begun to use opinion polling on a far wider basis. With politics becoming less ideological and political parties finding themselves fighting over the middle ground, opinion polls have become an important mechanism for determining subtle shifts in public opinion. And not only has polling become more commonplace, it has also been subject to adaptation; mechanisms such as focus groups and quality circles, which have their origin in marketing, are now used to test public opinion both on broad political issues and specific policy proposals. Democracy and Deliberation Yet as this book demonstrates, deliberation has once again returned to the political agenda, as a range of western European countries have come to see the relevance of reconsidering the nature of participative structures as a means to establish the best methods to involve the public in the policy process. Developments considered within this book, such as health panels in Britain and planning cells in Germany, each reflect the desire to widen involvement in the policy process beyond the traditional networks of interest groups, and in doing so, they seek to introduce a level of reflection or deliberation into this more inclusive process. Such a concern has been at the heart of recent attempts to restructure the workings of opinion polls. The deliberative tradition within the democratic process has a history which dates back to the Greek city states. It finds contemporary support from those such as Dahl (1979), who considered that only deliberation can give citizens an “enlightened comprehension” of political issues. More recently, the work of Jürgen Habermas has emphasized the need for discursive procedures as a precondition to establishing the common good (Habermas 1981, 1992). Other authors argue that free and full discussion should help individuals to feel a tension between their personal interest and what they hope for society (Reich 1988). Finally, the evaluation of conflict resolution clearly shows that such conflicts originate in the main from self-interest, and discussion is often the best way to confront this self-interest and maximize collective benefits (Susskind and Cruikshank 1987). This has led to the development in recent years of a number of participative systems which all seek to promote this deliberative ideal within the broad tradition offered by opinion polling. One such development is James

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Fishkin’s deliberative opinion poll (Fishkin 1991, 1995). These so-called deliberative opinion polls gather together a representative sample of the population in the same location in order to discuss particular problems in a small group setting. The goal of these opinion polls is not to help predict a forthcoming election or vote; it is to establish what the electorate would think about an issue if they could have access to all the relevant information and be able to consider it in a deliberative setting. Fishkin’s polls operate in a similar manner to the health panels considered in Chapter 6 and the German system of planning cells in Chapter 5. Although such methods have proved increasingly popular in recent years, they can be prohibitively expensive, as organizers often pay travel and living expenses for the participants. Logistical issues relating to bringing a group of people together for a period of days or even weeks, further limits their potential for comprehensive use. This has in turn highlighted the need to consider more practical solutions, which can offer a workable compromise between the problematic but efficient model offered by traditional opinion polls and the more considered but resource-intensive model offered by deliberative opinion polls. In this chapter, I shall consider the choice questionnaire as one alternative. The choice questionnaire was first developed in the Netherlands by Saris and his colleagues (Saris et al. 1983; Neijens 1987) as a means to involve the public in the general social debate on nuclear energy that was taking place at the time. Their aim was to provide a means by which a representative sample of respondents could be provided with wide-ranging information and given help to make use of it, in order to make considered choices concerning the future energy policy of the country. The aim of this chapter is to present an evaluation of the choice questionnaire. I shall do this by discussing the research findings of a Swiss case study which sought to evaluate the choice questionnaire as a tool for establishing the public’s view on transport management policy related to the use of cars. In the light of the research findings, I will examine the long-term prospects for the choice questionnaire and ask whether it represents a return to Gallup’s original idea of opinion polls as arenas for public deliberation. But before examining how it works, I shall briefly place the Swiss trial into the context of recent political history. Swiss Democracy and the Deliberative Ideal For outsiders the Swiss political system represents one of the more active of European democracies, a country in which public participation constitutes an integral part of the political system. At the heart of Swiss democratic practice lie referendums and popular initiatives, which are held at both state and local level. Referendums give citizens an ultimate power of veto, in the sense they can accept or reject any parliamentary bill. At a national level, most parliamentary bills are subject to a referendum if demanded by a petition of 50,000 citizens or more.2 Where these bills concern constitutional amendments or international treaties,

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they are automatically put out to public consultation. Besides this reactive power, Swiss citizens also have a proactive power in that with a minimum of 100, 000 signatures they can start a popular initiative, and in doing so introduce a new constitutional amendment. Similar systems also operate at the level of the region (canton) and the locality (commune), although there is little consistency of approach across local practices.3 These instruments of direct democracy can be said to constitute a pillar of the Swiss collective identity and are underpinned by a high level of public support (Longchamp and Hardmeier 1991). However, the idyllic vision of a country with a political system allowing the active participation of citizens in public affairs is brought into question by the low levels of turnout (a mean of around 40 per cent), and more generally by the apparent lack of interest in politics among the public. Furthermore, recent studies have shown that Swiss citizens are often unable to put forward informed opinions on issues relating to complex problems (Bütschi 1993). Political life in Switzerland is built around the citizen to a greater extent than in any other European country. Nevertheless, high levels of public participation are not easy to achieve, as many people lack the interest and the knowledge to take an active part in the political process. This often leads to the situation described by Offe and Preuss (1991), where although everyone has an equal chance to participate in political decisions, the mechanisms of direct democracy do not guarantee that people have developed fully considered preferences about the issue to be voted on. So even in a situation like Switzerland, where extensive structures for direct democracy have been established, there remains a desire to explore forms of public participation that would give citizens the opportunity to express considered opinions based on an informed consideration of the issue under scrutiny. The Choice Questionnaire Based on the principles of decision theory, the choice questionnaire is designed to provide a highly sophisticated method for establishing public opinion. Typically it is five to ten pages long plus separate information cards for each policy alternative to be considered.4 If completed in full, the choice questionnaire can take as long as an hour to complete by a single respondent. Given that the procedure for completing a questionnaire is quite complicated, interviewers will generally hand out the questionnaire in person and will be on hand to give instructions on how to complete it. The first part of the choice questionnaire sets out the details of the specific problem or policy area under consideration. It then lays out a number of potential alternatives for the resolution of the problem, and provides a brief written explanation about the procedure to evaluate each of them. Having done this—the most important part of the exercise—the choice questionnaire then gives the respondent information about each of the policy alternatives,

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highlighting their possible consequences on a series of information cards. The use of information cards is self-evidently problematic. Not only is there a limit to the information a set of cards can contain, but also there is the potential to provide only a limited number of views or to provide information that is biased or incorrect. As a result, it is recommended that a panel of experts should help put together the information cards, and it should be made clear to respondents that the information contained on the cards cannot be viewed as constituting the whole picture. The information provided as part of a choice questionnaire can help respondents to make considered choices, but it does not guarantee that they will. To help ensure that respondents’ views are considered, the choice questionnaire goes a step further by building into it a structured evaluative process. Information cards are constructed so that respondents can evaluate the attractiveness of each policy alternative by examining the attractiveness of a series of related policy outcomes. Figure 4.1 provides an example of how one such policy option and its related outcomes are presented on an information card, as well as the procedure used to judge their respective attractiveness. Respondents must first indicate whether or not they consider each of the listed outcomes to be relevant. In cases where they do feel an outcome to be of relevance, they are then asked to indicate how significant they consider this to be. Where respondents consider it to be an advantage or a disadvantage, they mark this down in the first or second column, respectively. Having done this, respondents must then total up the scores given to both advantages and disadvantages, in order to come to an overall judgement as to the attractiveness of each particular policy option. Once respondents have evaluated the different policy alternatives, they are then required to prioritize them. Firstly, they are asked to rank the policy alternatives in order of preference. Then they are asked to choose their three preferred options, which constitute their proposed package of policy reforms. The most common rule of choice highlighted by decision theory is certainly the addition of utilities, which holds that individuals will total the benefits provided by each option; in the choice questionnaire this means that individuals would choose the three policy alternatives with the highest total scores. However, the link between evaluations and choice is much more complex, and previous experience has shown that individuals have often used idiosyncratic decision rules to order each policy option and to make their final choice. While some clearly used the rule of addition of utilities, others based their choice on more, or quite often less, elaborate systems, such as looking only at total advantages or disadvantages, or considering only an isolated consequence or two (Bütschi 1997). In summary the choice questionnaire offers an alternative to traditional opinion polls, where respondents are often asked to give their opinion about issues they have not previously thought about, by providing respondents with arguments for or against each policy option and a mechanism to prioritize them.

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Figure 4.1 Information card: presenting the options for a choice questionnaire.

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To an extent, the choice questionnaire provides a hybrid that combines the practical flexibility of the traditional survey with the deliberative aspects of the focus group or citizens’ jury. Perhaps “deliberative” is not a wholly appropriate term given that, prior to completion, a respondent would not normally be expected to discuss the issues in the questionnaire with any outside party. It may be more appropriate to consider the choice questionnaire as fostering a form of self-reflection rather than deliberation. Environmental Improvement and the Choice Questionnaire: A Swiss Case Study The choice questionnaire was first used in Switzerland as one component of a substantial piece of academic research which sought to establish public attitudes to a range of measures aimed at reducing the environmental impact of cars.5 The research programme aimed to establish not only people’s views, but how their initial opinions varied from those where individuals had been confronted with different kinds of information: whether gained through the choice questionnaire, through political campaigns or through the media (Kriesi and Bütschi 1997). It did this by developing three quasi-experiments (Campbell and Cook 1979) that involved three different questionnaires. The first was conducted by telephone in the autumn of 1993, with a representative sample of around 2,000 Swiss citizens. Approximately six months later, half the sample were involved in face-to-face interviews. During this period, an important public debate took place in Switzerland on transport policy, with citizens having to vote on several issues related to this theme, including a proposal to put a tax on carbon dioxide (CO2) emissions. This high level of debate provided the first way to examine the effects of information and deliberation on individual opinions. The second way was to provide respondents with a copy of the choice questionnaire at the end of the second interview. The questionnaire put forward for consideration the same eight policy alternatives, all of them aimed at reducing the environmental problems caused by motor cars. The choice of eight policy alternatives was obviously somewhat arbitrary, in that many more could have been added to the final list. Yet it was considered important that the choice questionnaire did not overload respondents with too many options, as this could jeopardize their ability and motivation to give each one the same amount of consideration. To produce a workable set of policy alternatives, a group of environmental experts was brought in. They agreed on a mix of measures: some clearly designed to restrict car use; some to provide fiscal incentives in exchange for more ecological behaviour; and some that encouraged technical or organizational solutions. Each of the eight policy alternatives varied with respect to its likely impact on motorists, the level of complexity it involved and its pre-existing public profile. It was expected that each of these characteristics would significantly affect how respondents viewed each policy alternative.

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The first policy alternative involved the promotion of technical improvements to private cars, such as the installation of better catalytic converters or more fuelefficient engines, whereas the second suggested replacing some traditional cars by electric cars. The third alternative promoted carpooling as a means of reducing the total number of journeys. These three measures were viewed to have only a minor impact on car drivers, as they were based on individual drivers making conscious voluntary decisions. The fourth option, to introduce car-free zones into inner cities, was a more radical measure supported by a number of ecology groups, and this sat beside the fifth option which proposed increasing parking charges. The final three measures were viewed to have the greatest potential impact on motorists. The first envisaged a speed limit of 100kph on national highways, with the aim of reducing emissions. This measure had been considered a number of times in the past and it had a high public profile.6 The final two measures were both related to increasing the cost of fuel, thus fulfilling the polluter pays principle. The first envisaged an increase of 8–9 per cent, a figure environmental activists felt inadequate to change driving habits, whereas the second proposed a more radical year-on-year increase of around 15 per cent up until the year 2000. Of the eight proposals, speed limits, car-free zones and electrical vehicles all had relatively high public profiles, although the relative complexity of each varied substantially. These variations must be considered when trying to understand the impact of the process of self-reflection on which the choice questionnaire is based. Whether a measure imposes fewer or greater constraints on the motorist, is known by the public or unfamiliar to the public, is easy to understand or hard to understand and implement, all will affect both the nature and level of the deliberative process. Undertaking the Choice Questionnaire One of the first questions to consider is whether respondents will be motivated and competent enough to complete the questionnaire, and hence engage in a process of self-reflection. In the Swiss example, the choice questionnaire was completed and returned by 88.2 per cent of the people who received it, with the profile of respondents broadly reflecting the initial sample. Nor did an analysis of cognitive resource indicators (which assess a respondent’s ability and motivation) demonstrate any significant differences between those who returned the choice questionnaire and those who did not. So, contrary to initial fears, respondents appeared both able and willing to undertake the exercise. On an even more positive note, over 80 per cent of respondents said the information provided by the choice questionnaire had been of a high quality, and 75 per cent of them judged the choice questionnaire a good instrument in helping form their opinion on the subject in hand. However, the high overall response rate disguises the fact that a large number of respondents did not consider all the information that was made available to

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them, while a significant minority failed to complete the questionnaire in full. Of these partial respondents, a majority were less knowledgeable about environmental issues and had lower levels of educational qualifications than those who completed the questionnaires in full. Although there was concern that response rates would be skewed towards those who viewed environmental issues most seriously, this was not found to be the case. Variations with respect to political allegiance, levels of political mobilization and ecological predispositions did not prove to be significant. Similarly, no apparent skew was evident with respect to car drivers and those who predominately used public transport. However, while the procedure itself was generally free from selective bias, this cannot be said for respondents’ consideration of individual policy consequences. The research established that the way respondents evaluated the consequences presented in the choice questionnaire was strongly associated with the opinions they held with respect to the policy option before they had completed the choice questionnaire. The research also pointed to respondents’ overall evaluations being dependent on their knowledge about the environment and their attitudes to ecological issues. This element shows that even though deliberation, or more accurately self-reflection, allows individuals to be confronted by new ideas, they do not enter into this process free from preexisting values and beliefs. Deliberation and the Choice Questionnaire The central question therefore remains, Did the choice questionnaire succeed in generating considered opinions, and in doing so, did respondents move away from what the public involvement matrix calls a particularistic stance towards a holistic (or universalistic) stance? Generally speaking, most respondents had already thought about at least some of the proposed alternatives, so we cannot consider the choice questionnaire to have operated in a policy vacuum. Nevertheless, about 60 per cent of respondents agreed they had a more differentiated understanding of the proposed alternatives having completed the choice questionnaire, and more than 50 per cent claimed their choices were underpinned by better arguments. Another way to help estimate the effects of the choice questionnaire on opinions, is to consider opinion changes which occurred between the face-toface interview and the end of the choice questionnaire. Table 4.1 considers the eight policy measures selected for analysis and presents the proportion of respondents whose opinion changed between the face-to-face interview and the choice questionnaire.7 It demonstrates that a majority of respondents kept the same opinion for the duration of the study. This result is far from surprising, given that such a short period of time separated the two questionnaires and given that the choice questionnaire often served to reinforce existing opinions. It is also interesting to note that less dramatic shifts of opinion, e.g. from “strongly

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Table 4.1 Variations of respondents’ opinions (percentages)

disagree” to “disagree”, were far more common (Bütschi 1997). The proportion of respondents who changed their mind having completed the choice questionnaire varied from one policy option to another, with change more likely in cases where the policy under consideration had a more complex nature, such as electric cars and parking restrictions. A high public profile had no marked impact on the issues under consideration and it cannot be considered of central importance. When considering the impact of deliberation on people’s views, it is much more important to notice that where change did take place, the movement tended to be towards what may be termed a more pro-ecological position or opinion (Table 4.1). This finding is of particular note, since changes that were observed between the first telephone interview and the face-to-face interview were more towards an anti-ecological position (Kriesi and Bütschi 1997). However, this does not mean that a self-reflective procedure such as the choice questionnaire automatically creates more environmentally friendly opinions. Examined as a whole, most arguments presented in the choice questionnaire could be deemed to be pro-ecological, because the idea was not to propose a neutral view of the problem, but a rather realistic outline of the situation provided by the experts. What it does appear to show is that the form of selfreflection offered by the choice questionnaire can affect opinions, even in cases where the implications of a policy option may be quite detrimental to the individual concerned.

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Considered Opinions: The Role of Information What remains unclear is the process by which the choice questionnaire actually operates, particularly the impact of information and the process of deliberation or self-reflection. In short, are changes in opinion which occurred after individuals completed the choice questionnaire a result of the provided information being considered via a process of self-reflection, or are they the result of what Converse (1964, 1970) termed an individual’s “non-attitudes”, i.e. random answers. As I have already said, there is a limited potential for information to change a person’s mind. This is because a respondent will have their own preconceptions, values and beliefs, and also because information flows do not convey a single message but a series of contradictory arguments. The media, for example, carry and transmit opposing messages, so it is little wonder that academics have not been able to establish a strong link between what the media say and what the public think (Zaller 1992). This points to the belief that the presence of contradictory arguments in the choice questionnaire may in fact impair its strength as a persuasive instrument. And as one would expect, where the information conveyed does not contradict prior opinions, the effect of this new message would be to reinforce pre-existing opinions rather than to change them. Results of the choice questionnaire held during the general social debate in the Netherlands demonstrated that respondents with a strong prior opinion were less likely to change their mind. But the opposite was found for respondents whose prior opinion deviated from the evaluations given in the information card (Neijens 1987). Similar results were looked for in the Swiss case, and the relationship was explored between strength of opinions held during the face-toface interview (preceding the choice questionnaire), prior instability (i.e. changes which occurred between the first two interviews) and discrepancy of prior opinions with overall judgements of a measure (Bütschi 1997). Then it could clearly be showed that people who had already changed their mind before completing the choice questionnaire were more likely to change it once again when completing the questionnaire. Moreover, respondents who had a middleranking opinion, i.e. who answered by either “rather agree/disagree” or “don’t know”, also proved more likely to shift their opinion having filled in the choice questionnaire. Finally, and perhaps of greatest interest, it appeared that respondents whose prior opinions would contradict their overall judgements were also more likely to change their opinions. Then, contrary to Converse, who states that opinion changes reflect random fluctuations, it could be proved that for at least a significant group of respondents, opinion change is in fact the result of a process of self-reflection induced by the choice questionnaire. And this process of self-reflection was even stronger for individuals who had already demonstrated hesitancy with regard to the policy alternatives under consideration, as opinion changes due to the contradiction between prior opinions and overall

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judgement had an especially marked effect on individuals who had already changed their mind during the two first interviews. Conclusions The choice questionnaire is a new system for opinion polling which draws upon the deliberative ideal laid out by George Gallup. It originated in the Netherlands, where it has been applied to establish views on the continued use of nuclear fuel, and as a precursor to a vote on traffic management in the city of Amsterdam. In the Swiss case study considered here, the choice questionnaire was used as part of a larger academic study which sought to establish variations in public opinion when confronted with different types of information. The findings of the study established that the choice questionnaire had a good response rate and that a majority of respondents completed most, if not all, of the questionnaire. The effect of the choice questionnaire, while marginal, generally led respondents to adopt what may be termed a more environmentally friendly position. However, observed changes would differ from one measure to another, suggesting that empowerment may lead to various processes and results according to the issue under consideration. Finally, it could be shown that the choice questionnaire has the greatest impact on ambivalent individuals, as they are more likely to consider new information or viewpoints. The choice questionnaire is the only mechanism in this book that is simultaneously individualistic and holistic. Although a whole population completes the questionnaire, each member completes it in isolation. People are not intended to come together to complete their questionnaires nor is it intended that they will discuss the issue at hand in any structured way. In this sense it only leads to an aggregation of subjective considered preferences. Yet the choice questionnaire also seeks to draw the individual away from a self-interested view and through the process of deliberation, or more correctly self-reflection, they should come to a decision which is more in line with a reasoned general will. This individualistic yet holistic categorization rests on the premise that the choice questionnaire involves a degree of deliberation. However, as has been said, it is better to talk about self-refection or virtual deliberation, in that a person does not have to listen to another viewpoint if they do not wish to, nor do they have to justify their own views to others. Moreover, interlocutors of respondents are not their peers, but experts. Deliberation in this context simply refers to a process by which respondents are presented with a range of structured information along with an evaluation procedure, and they are asked to consider them before making their decision. The questionnaire itself may have a level of internal logic built into it, but respondents are free to ignore this when evaluating each policy option. The way information is provided as part of the choice questionnaire has been shown to influence opinions; and the nature of the influence depends on prior opinions as well as more general predispositions and values.

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Limitations of the Choice Questionnaire Setting aside the issue of deliberation, one can identify a number of additional issues with which the choice questionnaire must contend. Some of them relate to the mechanics of the questionnaire, and although seemingly minor, they could lead to substantial problems if not adequately addressed. How can one ensure that respondents receive unbiased information? Bringing together a range of experts for what was primarily an academic exercise would become more problematic if the issue under consideration was highly controversial, and if it was the government not an academic institution that was responsible for collating the information in the first instance. And even if this problem could be overcome, we are then left with the possibility that respondents could misinterpret or misunderstand the information that is presented to them. On a broader level, the choice questionnaire is structured to operate most effectively when the decision to change policy has been made and discussion is merely on how to change it. However, when giving power to the people, one might be concerned to find out their own solutions, perhaps ideas which experts or decision makers have overlooked. In this sense the logic of the choice questionnaire lies nearer to the logic of voting in referendums, where people have to state whether or not they agree with the proposed project, even if none of the options appeals to them. The Future Potential of the Choice Questionnaire In Switzerland, where direct democracy already allows the citizen to take part in formulating specific government policies, empowerment strategies such as the choice questionnaire can nevertheless have significant potential. Replacing voting procedures by the choice questionnaire may well represent a retrograde and undemocratic step, an opinion shared by more than 70 per cent of respondents, but its use as part of a wider consultation exercise may have two main advantages. Firstly, as was the case with the Dutch government during the general social debate, Swiss authorities could use this type of sampling instrument to better understand the views of the public in relation to complex and controversial issues. Such issues, especially those with environmental consequences, confront the political system with two crises, and greater public involvement might constitute a way to break the impasse. The first is the decision-making crisis caused by the uncertainty inherent in problems such as the greenhouse effect, where there is an absence of clear direction within the scientific community. The second can be described as a crisis of legitimation, where a polarization of political opinion is observed. In these cases, where experts may be able to solve the decision-making crisis, public involvement within a general social debate is crucial to solving the wider legitimation crisis. Of course, citizen involvement could take any of the forms discussed in this book. However, in the field of

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environmental protection, even though some decisions may be taken at the level of the individual, the decision-making process must seek to involve the whole community in order to seek to establish the common good. And even though the choice questionnaire does not in itself constitute a holistic form of participation, it is nevertheless addressed at all citizens (or a least at a representative sample of them) and involves highly diverse subjectivities. Secondly, the choice questionnaire offers significant potential as an adjunct to direct democratic systems, such as a referendum or a vote on a popular initiative (Neijens et al. 1996). Votes and referendums can present citizens with highly complex issues, and the less politically sophisticated encounter some difficulties in being able to participate fully.8 Then the choice questionnaire may help citizens to better understand the issues on which they have been asked to vote, and to express opinions which better coincide with their own interests and values. It is clear that if the choice questionnaire were to be used for popular consultations, it would have to be distributed to all citizens. This may not prove a problem in Switzerland, given that the Swiss government (as well as cantonal and local governments) already sends all registered citizens an information leaflet, which outlines the law to be voted on, as well as its recommendations about the vote and the arguments of the opposition (generally groups who demanded the referendum or launched an initiative). So rather than establishing a cheap and reliable method to reintroduce deliberation into the polling process, the best that can be said for the choice questionnaire is that it could be used to help establish the conditions for citizens to fully participate in the democratic institutions of a country such as Switzerland. But whatever the arena for the choice questionnaire, it still takes a political decision to move the issue forward. Even if the choice questionnaire offers favourable conditions for citizens to form considered opinions, it is likely to remain no more than an academic exercise as long as political authorities prove themselves less than willing to foster the appropriate conditions for democratic participation. Notes 1. This chapter is based on my doctoral thesis, which I wrote at the Department of Politics, Geneva University. I am especially grateful to Hanspeter Kriesi, who accompanied me during this lengthy process, and who gave me theoretical and technical support. 2. The population of Switzerland is about 7 million. 3. At the national level, popular initiatives are restricted to constitutional amendments. At the regional or local level, they can propose new laws or bills. 4. In the Swiss case, the information cards were not handed out separately, but were part of the leaflet. This procedure, however, proved to be rather confusing, as respondents could not “physically” order the policy alternatives (Bütschi 1997).

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5. The whole project was subsidized by the Swiss national foundation for scientific research, and was part of the Priority Programme for Environment. Some addi tional support was provided by the Federal Office for Education and Science, as the project was also integrated in a European project (Cost Action 614). 6. In 1989 a highly contested referendum demanding the reinstatement of the speed limit at its previous level (130km/h) was finally turned down. Two years later, experiments to introduce a speed limit of 100km/h on certain parts of the Swiss national highways system particularly exposed to ozone pollution during the summer, met with stiff public resistance, particularly from motoring organizations. This has left unsolved the question of speed limits on highway sections going through urban areas. 7. Even though opinions were measured through the use of five categories (totally disagree, rather disagree, do not know, rather agree, totally agree), this case considered whether a person agreed or disagreed with the opinion. 8. Held (1987) describes this situation as being a cause of democratic inequalities, whereas Gaxie (1978) speaks of “hidden census”.

References Bütschi, D. (1993) “Competence Pratique”, in Kriesi, H. (ed.) Citoyenneté et démocratie directe: competence, participation et decisions des citoyens et des citoyennes. Zurich: Seismo, pp. 99–119. Bütschi, D. (1997) Information et Opinions: Promesses et Limites du Questionnaire de Choix. Geneva: University of Geneva. Campbell, A. and Cook, T. (1979) Quasi-Experimentation: Design and Analyisis Issues for Field Settings. Chicago IL: Rand McNally. Champagne, P. (1990) Faire l’Opinion: le Nouveau Jeu Politique. Paris: Editions de Minuit. Converse, P. (1964). “The nature of belief system in mass publics”, in Apter, D. (ed.) Ideology and Discontent. New York: Free Press, pp. 206–61. Converse, P. (1970) “Attitudes and non-attitudes: continuation of a dialogue”, in Tufte, E. (ed.) The Quantitative Analysis of Social Problems. Reading MA: AddisonWesley, pp. 168–89. Dahl, R. (1979) “Procedural democracy”, in Laslett, P. and Fishkin, J. (eds) Philosophy, Politics and Soeciety. New Haven CT: Yale University Press, pp. 97–133. Fishkin, J. (1991) Democracy and Deliberation: New Directions for Democratic Reform. New Haven CT: Yale University Press. Fishkin, J. (1995) The Voice of the People: Public Opinion and Democracy. New Haven CT: Yale University Press. Gallup, G. (1939) Public Opinion in a Democracy: The Stafford Little Lectures. Princeton NJ: Princeton University Extension Fund. Gaxie, D. (1978) Le Cens Caché. Paris: Seuil. Habermas, J. (1981) Theorie des Kommunikativen Handelns. Frankfurt: Suhrkamp. Habermas, J. (1992) Faktizität und Geltung. Frankfurt: Suhrkamp. Held, D. (1987) Models of Democracy. Cambridge: Polity Press. Kriesi, H. and Bütschi, D. (1997) Opinion Formation and Change: The Case of the Swiss Policy Against Air Pollution Caused by Cars. Geneva: University of Geneva.

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Longchamp, C. and Hardmeier, S. (1991). Democratie-Reform und Europäische Frage. Bern, GfS Forschungsinstitut und Universität Bern. Neijens, P. (1987) The Choice Questionnaire: Design and Evaluation of an Instrument for Collecting Informed Opinions of a Population. Amsterdam: Free University Press. Neijens, P., Minkman, M. et al. (1996) “A decision aid in a referendum”, International Journal of Public Opinion Research, 8, 1, pp. 83–90. Offe, C. and Preuss, U. (1991) “Democratic institutions and moral resources”, in Held, D. (ed.) Political Theory Today. Cambridge: Polity Press. Reich, R. (ed.) (1988) The Power of Public Ideas. Cambridge MA: Harvard University Press. Salmon, C. and Glasser, T. (1995) “The politics of polling and the limits of consent”, in Glasser, T. and Salmon, C. (eds) Public Opinion and the Communication of Consent. New York, Guilford Press, pp. 437–58. Saris, W., Neijens, P. et al. (1983) Kernenergie: ja of nee? Amsterdam: SSO. Susskind, L. and Cruikshank, J. (1987) Breaking the Impasse: Consensual Approaches to Resolving Public Disputes. New York: Basic Books. Zaller, J. (1992) The Nature and Origins of Mass Opinion. Cambridge: Cambridge University Press. Zukin, C. (1981) “Mass communication and public opinion”, in Nimmo, D. and Sanders, K. (eds) Handbook of Political Communication. Beverly Hills CA: Sage, pp. 359– 90.

CHAPTER FIVE Planning Cells: The German Experience Peter C. Dienel

Introduction The planning cell system was first used in the German town of Schwelm in 1972. Since then planning cells have been used 155 times in 39 different locations and have proved an effective aid to resolving hardened conflicts and producing consensual outcomes. The success of the planning cell system in Germany has also had a direct impact on the policy process in other liberal democracies, most notably with the development of citizens’ juries, which have drawn upon many of the features of planning cells (Crosby et al. 1986; Coote and Lenahan 1997). Having been involved since the outset, over 25 years ago, I wish to present a personal overview of how planning cells work, for I believe they offer an important means of developing a more inclusive and democratic society. The Public and the Policy Process Within the traditional framework of liberal democracy, the citizen is presented with few, if any, opportunities to directly influence the process of producing collectively binding decisions. Yet this process has lain at the heart of societies as diverse as the old Indonesian village, the Swiss Talschaft or the classical Athenian city, where a direct model of citizenship was based upon communities in which face-to-face relationships were considered paramount (Held 1987). Today, while such close involvement in the policy process still exists within the immediate locality, this is largely limited to the consideration of small-scale policy implementation issues such as the devising of a social programme for young alcoholics, or an agreement on the placing of a new leisure centre. To work properly, collective public involvement should satisfy three criteria. Firstly, those who are involved in the policy process should be informed about the topic in hand. They need to know enough about its history and the policy alternatives under consideration. Secondly, they should be able to recognize the common good and they should be willing to build agreement around it. Finally, the participants should be motivated to take part in the problem-solving process. But the way the state operates in modern society means that beyond the

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realms of neighbourhood affairs, at least one of these three criteria is absent. It is most common to find that people are not sufficiently informed about what may be termed the bigger issues, hence they find it more difficult to establish the common good. Therefore the public rarely engages with the policy process at this level. The problem today is that many policy issues are simply too complex to be solved at neighbourhood level. Modern society can no longer be understood as an agglomeration of small villages. The important problems, the real problems, have to be settled at a higher level. Yet when one examines this macro level, one finds the policy process in the hands of an administration, a court, a parliament, a commission chairwoman, an NGO, or a citizens’ group. Macro policy is in the hands of professional citizens—that 10 per cent of the population that have the time and the resources to inform themselves, to ponder on a problem and to act as they wish within the confines of liberal democratic accountability (Moyser et al. 1992). The Centralizing State As the policy process grows more complex, so it appears do the systems designed to manage it. Despite recent improvements in information technology and management systems, the number of people working full-time in the field of macro policy continues to grow (Osborne and Gaebler 1992). Although it is not clear how much of this increasing complexity is unavoidable, there is no doubt that it brings additional problems. Firstly, there is the broadening gap between the so-called policy experts and the rest of society. This trend is unlikely to improve the already delicate relationship between the general public and the bureaucracies which serve them. Secondly, the growth of such bureaucracies is likely to distort the decision-making process itself, as politicians become increasingly focused on re-election rather than pursuing the common good (Niskanen 1971). One way to counter such tendencies would be for the public to regain a degree of control over the political and administrative system. Rebuilding Citizenship Public involvement in the policy process of most Western liberal democracies is the exception not the rule. This has created a two-tier model of citizenship. On the one hand are the active citizens, the 10 per cent of the population who involve themselves very closely with the policy process. Beyond this are the apathetic citizens who, consciously or unconsciously, believe there are inadequate opportunities to engage in public decision making and who respond accordingly. Yet these selfsame apathetic citizens are also capable of mutating into aggressive citizens, who may turn to violent demonstrations and protests if they feel their fundamental interests are being threatened.

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A system based on just these two types of citizen will by its very nature provide little opportunity for democratic engagement. The 90 per cent of the population who are not active citizens appear to constitute a black hole within the political system, their anxieties, likes or dislikes and wishful dreams registered largely through opinion polls. And while politicians may like to view these poll findings as an expression of public opinion, this would be a mistake as they are merely an account of unconsidered views. We have a democracy of spectators; and for this to change, so too must the manner of public involvement in the policy process. Just as we produce a surgeon or a chemist, so we must produce a citizen. The macro problems of our “risk society” must be tackled (Beck 1992). Rational solutions must be sought, even if they appear controversial. For the public themselves, new avenues should be opened up which offer possibilities of finding meaning and identity. It is not necessary to change human nature to achieve these goals, nor is it a matter of a more formally educated public. Rather, there is a need to address the policy process itself. Problems have to be prepared in such a way that people can handle them, regardless of whether they have access to the Internet or possess a high level of formal education. Having prepared the problems, the next step is to create a process which can address them, and which is both collective and deliberative in its workings. This is the aim of the planning cells. The Planning Cell Process A planning cell is a group of 25 people from across the social spectrum who work together for a strictly limited time. With the help of two moderators, they learn about an issue delegated to them by a commissioning body and they consider a number of alternative solutions. During the last 27 years, thousands of people have been involved in planning cells and many lessons have been learnt. The idea has been tested thoroughly and has proven applicable to a range of different circumstances. The aim here is not to provide a manual, but to explain the basic processes and set out the continuing challenges. To begin with, here are what I consider to be the four fundamental principles. • • • •

Members of planning cells should be chosen at random. Members should be given all relevant information. Recommendations are reached through a process of deliberation. Recommendations are fed back into the policy process in a meaningful way. Selecting Participants

There are two reasons for selecting participants at random. Firstly, it helps to ensure they reflect the communities from which they are drawn. Secondly, it

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reduces the likelihood of the planning cell becoming colonized by pre-existing activists. This is the same reason that Britain and the United States use stratified quota sampling when running citizens’ juries. And the difference of approach has a simple explanation. While the random group of 15 people required for a citizens’ jury can hardly be expected to mirror the composition of the wider society from which they are drawn, the assertion appears more sustainable for a planning cell project which can constitute up to 300 people. During the period since planning cells were first used, it has been found that in general the 25 members of each planning cell have mirrored the social composition of the population from which they are drawn (Dienel 1997). This applies to issues such as gender, age and social class. However, it also appears to hold for wider trends and attitudes. In a planning cell organized to look at transport issues in the city of Hannover, the transport usage patterns of the members proved similar to those of the Hannover population as a whole. This fits in with the work of academics such as Burnheim (1985). In a discussion of what he terms “demarchy”, Burnheim has spoken of the desirability to have public services managed at the local level by members of the public who are randomly selected to represent their community’s interests. Informing Participants Planning cells quite often deal with complex issues. So, within the constraints of a four-day time period, the process has been designed to allow participants access to the broadest possible range of views and information. In relation to the task itself, planning cell members are only ever asked to consider a single concrete task, such as access to public transport for people with disabilities. The implementing committee which oversees the planning cell process will already be aware of what information the participants may wish to access. And besides the information package, supplied in a broad range of media, participants are also encouraged to call expert witnesses and make site visits where appropriate. Time is perhaps the most important factor of all. One has to have the time to listen, to understand, to ask questions, to discuss alternatives and to make up one’s mind. Participants are given this time, although past experience has shown they assimilate information surprisingly quickly. By the second day of a planning cell, older people and young sales assistants are able to understand and communicate quite technical terms. In fact, the ability of lay participants to understand and work with complex ideas was constantly underestimated by the experts and politicians taking part as witnesses or speakers (Dienel 1997). People’s time is considered so important that the original facilitators of the planning cell project built in a properly costed fund to pay all participants an allowance on top of full recompense for loss of earnings. The children of participants are also given a place in a kindergarten. These measures aim to ensure that a greater range of people will be willing and able to participate, but

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they also attempt to reinforce with all parties the seriousness and importance of their task. The Deliberative Process Each planning cell has 25 participants. However, the majority of the work they carry out is within the setting of the small group session. During the four days the average planning cell will meet, each of the participants spends most of their time with four other people working in small groups. These five-person groups are charged with examining a particular issue which the planning cell as a whole has determined to be of particular interest or relevance. This may involve them in a discussion concerning a particular policy option or it may involve a more practical task, such as evaluating how easy or difficult it is to take a pram on different forms of public transport. Whatever the focus of the small group’s work, participants are encouraged to adopt a deliberative approach at all times; and in order to prevent the emergence of group hierarchies, membership rotates at random from session to session. It is in the groups that individuals move away from instrumental reasoning, and it is the groups which constitute the heart of the planning cell process. Observation has established that the deliberative style, combined with the rotating membership, helps planning cell members to move away from an instrumental perspective and towards a more holistic one. Yet the small group process retains the capacity for individual participants to voice their own opinions, and according to observation, this is just what they do. For instance, during the 1, 100 group sessions of a 14-cell project on information technologies, more than 40,000 task-oriented verbal contributions were recorded (Dienel 1997). The deliberative nature of the planning cell model reaches beyond the immediate process itself. In the weeks following a planning cell, participants will continue to discuss issues raised during the process with friends, family and work colleagues. In one piece of follow-up research, it was established that the 127 participants had recorded over 17,000 minutes of such conversation (Garbe 1986). Yet when a planning professional acted as an official observer on a planning cell, although he recorded every request to speak at the daily plenary sessions, he did not attend one of the 40 small group sessions (Bongardt et al. 1985). The use of small groups provides one of the most interesting comparisons between planning cells and citizens’ juries. Citizens’ juries in the United States usually work in plenary sessions, rather than dividing up into small groups (Crosby et al. 1986). Processes of this kind are still influenced by their understanding of the jury, assimilating evidence and coming to a single decision as a group. A number of the juries run in Britain have included some small group sessions on their agenda (Coote and Lenahan 1997). However, for the planning cell process, experience has shown that the advantages of retaining the

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small group approach as the central building block of the deliberative process outweigh the benefits of working within a single plenary group. Of course one drawback of the planning cell process is that, in working with such a large number of small groups, a great deal of data is produced. This cannot be handled in a purely qualitative manner, so quantitative techniques are used at certain stages in the process. However, considerable work is put in to ensure that participants understand how their opinions are being collated, and the planning cell process is not allowed to become a simple majoritarian exercise. Working with the Findings In order to build trust in the planning cell process, from the view of participants themselves, from those who fund and sponsor them, and from the wider community, they have been designed to feed directly into the wider policymaking process. As a starting point, all planning cell projects must have an official commissioning body, be it a local authority or a central government ministry. This provides an addressee for each citizens’ report, a body with power and authority to act upon the recommendations. Contrast this with citizens’ juries in the United States; they do not form part of the decisionmaking process and rely instead on the power of the media to forward their case (Meehan 1996). The aim of the citizens’ report, produced when a planning cell has completed its work, is to set out a series of recommendations based on deliberative principles. In order to avoid any likelihood of bias, participants will not have had any formal ties to organizations or interests which may be affected by their decisions. And given the short-term nature of the planning process, participants are presented with no opportunity for personal advancement, promotion or reelection. The aim is to ensure the planning cell process is seen to be neutral by participants, politicians and the general public. This is further reinforced by having a formal opening to the process, attended by a town mayor or some other office-bearer, and later on another ceremony where the citizens’ report is handed over to the sponsoring body by the participants of the planning cell. Planning Cells in Practice To make the project work effectively requires a substantial effort beyond running the four-day planning cells. Five phases can be distinguished: task selection, project design, preparation, implementation, documentation, and follow-up. Topic Choice The choice of topic is primarily a matter for the commissioning organization, usually a local council or central government department. In general, planning cells have only taken place when a commissioning body has been unable to resolve a problem itself and has felt compelled to involve the public. The task to

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be undertaken by the planning cell is then formulated by negotiation between the commissioning body and the organizing institute, although with some of the bigger projects it has been carried out by separate coordinating committees or an advisory council plus an accompanying board of trustees (Garbe 1986). In theory the planning cells could also be involved in determining the task to be considered, but this has never been done in practice. Sometimes the task cannot be sufficiently well defined for a planning cell to tackle it, then other methods may generate a manageable task. They include the Delphi methods used for a number of Stuttgart Akademie projects, or focus groups used by the Welsh Institute for Health (Webler et al. 1991; Iredale and Longley 1997). Yet while these and other means to establish topic areas have been put forward it is likely that negotiations between the commissioning body and the organizers of the planning cell will continue to be the main way for choosing topics. Preparing the Planning Cells Working alongside the sponsoring organization is the planning cell project team, and their role is to prepare the four-day programme of each planning cell. The project team will be involved in a number of key tasks which include contacting the different interest groups, employing expert witnesses and organizing the selection of participants. The project team will also play a significant role in employing the moderators for the plenary sessions, and producing the final citizens’ report. This project group function was originally carried out by the Participation Research Unit at the University of Wuppertal. However, the workload increased substantially as the planning cell process was used more regularly, so responsibility for running the planning cell project was taken over by CitCon, an independent self-financing institute located in Bonn and with branches in San Sebastian, Spain, and Beppu University, Japan. Once CitCon has selected the jurors, the chosen topic has to be translated into a programme of 16 work units. This is a crucial stage in the planning cell process because it must try to create an unbiased agenda where each work unit has a clearly defined remit and the problems have been reduced to a series of manageable alternatives. The responsibility for creating the work units falls on one individual; this person works as part of the planning cell project team and may be considered more influential than even the plenary session moderators. A further task which underlines the importance of the project team, is the preparation of the material that will be presented to the participants. Experience drawn from running planning cells in Germany shows that participants are often suspicious about the impartiality of the information they receive (Dienel 1997). This has led the planning cell project team to revise the information they give out to participants. Now the information is not only comprehensive but its

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presentation highlights the extremes of each argument so as to provide contrast and choice. Implementing the Planning Cell Project Unlike citizens’ juries, it is rare to have individual stand-alone planning cells. The average planning cell project consists of 6–10 individual planning cells and there have been nationwide projects of up to 24 planning cells working on the same problem along an identical four-day programme. Planning cell projects will typically operate over a four-day period, usually with two planning cells running in parallel with each other, one starting an hour later than the other. This system allows each expert witness to be deployed twice, which saves both time and money. The flow chart (Figure 5.1) presents a project that has 10 separate planning cells operating in such a manner. Every planning cell has two moderators, usually one female and one male. They are in charge of moderating the plenary sessions and keeping the four-day schedule on course. The moderators are trained not to demonstrate bias, although even following their professional standards, they may unconsciously radiate certain values and options. In order to cope with this probability, a project of 20 planning cells working to the same agenda and on the same problem will use up to 40 different moderators. The Citizens’ Report Once the planning cells have finished and the final plenary sessions have been held, the final citizens’ report is produced and printed by the planning cell project team. The report documents the task of the project, describes the process that has been undertaken, and summarizes the results and recommendations. The citizens’ report is then handed over to the commissioning organization, and each participant also receives a copy. The design, structure and operation of the planning cell process aims to produce a range of opinion and a large amount of data; and from the outset, the planning cell project team have adopted a largely quantitative approach with respect to processing this data. Processing is performed on a number of different levels, including individual decisions, small group decisions, and planning cell or plenary session decisions. Data processing also uses a number of different techniques, although generally preference is given to non-verbal opinion setting. For instance, an individual will be encouraged to express their opinion by deciding between dif ferent posters, by distributing countable units between one or more options, or by placing coloured stickers on a favoured solution. All these individual choices are then aggregated to provide a final series of preferred options. Plenary decisions forwarded by each planning cell will be compared to those of the other planning cells within a single project, and a majority recommendation goes forward for inclusion in the final citizens’ report.

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Figure 5.1 Running a planning cell project. (Adapted from the 1980 Cologne Town Hall Citizens’ Report).

The citizens’ report is produced by a lengthy process. Having collated all the data, members of the project team compose a first draft, which is sometimes discussed with participants in a special meeting held a few weeks after the end of the planning cell process. In several cases the draft edition has not only been discussed with the planning cell participants but has also been put to the wider community.1 The draft edition may also be sent to the planning cell participants together with a questionnaire, so they can feed back their views before any follow-up meeting is held.2 There are examples of questionnaires being handed

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out during follow-up meetings, alongside the presentation of the draft edition of the citizens’ report.3 In each case the aim of the project team is to ensure that planning cell participants are satisfied that the recommendations laid out in the final citizens’ report fully reflect their personal views. Towards this end, it is not unusual for the final edition of the citizens’ report to include additions, amendments, objections or supplements raised during this second period.4 In some projects, lay jurors are elected by their fellow planning cell participants to take responsibility for all or part of the editing work. Other projects have appointed special committees of participants to structure and formulate the citizens’ report.5 Cologne Town Square: A Planning Cell Case Study In the Cologne project, the planning cell was asked to consider whether to rebuild a small historic square in the war-destroyed area around the town hall, or whether to leave it as a common. The citizens’ report came out very strongly in favour of keeping the common. This conclusion was the result of a process which involved analyzing and comparing a number of alternative development models. Of the 50 small groups on the project, 11 recommended rebuilding the historic square and 39 voted to keep the common. The majority argument held there was a need to have an area in which to sit down and relax within the heart of their city and adjacent to a busy shopping area. Of particular importance is the fact this conclusion was supported by each of the ten planning cells that had been recruited to represent each significant geographic area within the city. The Cologne planning cell project was particularly interesting with respect to its scale and the response it generated. The ten planning cells cost DM 88,500 (Bongardt et al. 1985). The public’s response to the project as a new form of consultation initially focused on the cost. Although not high by the standards of many planning cell projects, the cost became an issue after a printer’s error (by a factor of 1,000) appeared in one of the leading Cologne papers (Bongardt et al. 1985)! Printing errors aside, the Cologne project did highlight the issues of scale and cost. If the city council in Cologne had simply wanted to know what options were available and how a small group of people viewed them, then the project could have been based around the cheaper and simpler option of a single planning cell. However, by combining the principle of deliberative enquiry which lies at the heart of the planning cell process with the breadth of opinion gained from a set of ten city-wide cells, the council was able to produce a set of recommendations which carried a level of legitimacy and considered correctness. And this meant the council felt confident to use those recommendations as the basis of its future policies.

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Financing Planning Cells While planning cells may be cost-effective for those who commission them, they still represent an expensive option. For example, a citizens’ report which examined the issue of commuter traffic in the region of Hannover cost approximately DM 400,000 (Dienel 1997). The 12 planning cells upon which the final report was based were made up of 300 participants selected from a crosssection of municipal districts within the Hannover area. The most expensive planning cell project, “The Telephone of the Future”, had 519 lay participants working at eight different locations all over Germany. In this particular case it was decided that participants would need to test out a range of information and communication technologies, which in turn required truckloads of technical equipment to be transported to the planning cell assembly rooms for each session. The German government provided finance to the tune of DM 820,000, but it did prove to be a very successful project. Planning cell projects vary in their scale and complexity, but sometimes the commissioning body will agree to meet certain running costs out of its own revenue funds for items such as room hire, data processing and printing. Although these agreements can help to reduce marginal costs, the costliest element is the reimbursement of the participants. Yet, as already explained, payment for participants remains one of the most important factors in securing people to take part and for the legitimacy for the process. The Future of Planning Cells Finance currently remains the central constraint to the further development of the planning cell model. A number of planning cell projects have broken down before implementation solely on the grounds of cost (Dienel 1997). But remember, despite being devised over 25 years ago, planning cells are still considered an innovation in the state-citizen dialogue, and they are currently being evaluated by a number of state agencies. Within the German government, planning cells have no formal or statutory role, but this is not unusual for a new innovation or development seeking to establish itself within the state sector. Even central elements of what is now the welfare state, such as schools and hospitals, were at one time local enterprises which relied on private and voluntary funding. Yet, in one way, keeping a distance between the state and the planning cell process should remain an important goal. Planning cells do not constitute a political equivalent to the legal jury. A degree of independence from the state is more likely to ensure that the planning cell process retains the trust and respect of the wider population, as representing an independent democratic forum for discussion, debate and appraisal. Citizens’ reports have proved themselves to be a cost-effective means of resolving a range of urban planning issues. They have led to a significant reduction in the total cost of the planning, statutory and legal processes. Planning

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exercises themselves often prove to be expensive and time-consuming. In Germany the length of time needed to authorize airport construction projects has been immense. The Frankfurt West runway took 17 years; the second runway at Munich took 20 years; the extension of a runway at Stuttgart took 14 years; while the decision not to expand Hamburg Airport took 25 years at a cost of DM 100 million (Dienel 1997). The figures indicate how long avoidable costs are allowed to mount up because machinery and planning experts stand idle, waiting for construction to begin. If mechanisms such as the planning cell process were used at an early stage, this might help to generate a consensus. There is good evidence that planning cells can help to resolve situations such as new roads and airports. One recent example is the routing of a new motorway in the Basque region of Spain; this was successfully addressed through the use of the planning cell model (Dienel 1997). A Route Forwards? In many ways the future for planning cells appears assured. The need to provide a quick, efficient and cost-effective means for resolving urban problems, in a manner that generates a broad degree of public legitimacy, remains a central preoccupation of public policy-makers. Planning cells offer one method of achieving this and they have the additional benefit of using a consultative framework built around a commitment to inclusive deliberation. In some ways one may even talk about planning cells having come of age. Along with my colleagues, I first developed the concept over 25 years ago, yet only during the last decade has it truly gained momentum. Extended forms of deliberative enquiry have at last been used to resolve public policy issues, first in Germany then in Britain, United States and Spain. Planning cells offer a way of helping to produce an informed and active citizenry which can effectively aid the development of public policy. The planning cell process helps people to think beyond their own individual or group interests and offers a way of moving towards decisions which reflect the common good in society. Notes 1. For example, the Bürgergutachten Energieversorgung Jüchen-Nord (Wuppertal University, 1984). 2. This happened with the 297 participants of a planning cell held in Hannover in 1996. 3. This occured during the four area meetings held before the Bürgergutachten Regelung sozialer Folgen neuer Informationstechnologien. For further details refer to the citizens’ report published by Wuppertal University in 1992 (4th edition). 4. For example, Bürgergtachten Zukünftige Energiepolitik (High Tech Verlag, Munich, 1985, p. 11 and pp. 173–7); Geographische Institute Univerität Bonn (Bürgergutachten Nordhausen, Cologne, 1998, p. 122).

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5 This occured after the 14 planning cells that were held for the Dictamen Ciudadano Maltzaga-Urbina, San Sebastian, 1994.

References Beck, U. (1992) Risk Society: Towards A New Modernity. London: Sage. Bongardt, P., Dienel, P. et al. (1985) Bürger planen das Rathausviertel. Frankfurt: Verlag Peter Lang. Burnheim, J. (1985) Is Democracy Possible? The Alternative to Electoral Politics. Cambridge: Polity Press. Coote, A. and Lenahan, C. (1997) Citizens Juries. London: Institute for Public Policy Research. Crosby, T., Kelly, N. et al. (1986) “Citizens” juries: a new approach to citizen participation”, Public Administration Review, 46, pp. 170–78. Dienel, P. (1997) Die Plannungszelle: Eine Alternative zur Establishment-Demokratie. Opladen: Westdeutscher Verlag. Garbe, D. (1986) “Planning cell and citizens” reports: a report on [West] German experiences with new participation instruments”, European Journal of Political Research, 14, 2, 221–36. Held, D. (1987) Models of Democracy. Cambridge: Polity Press. Iredale, R. and Longley, M. (1997) Citizens’ Jury on Genetic Testing for Common Disorders: The Origin of the Question. Glamorgan: University of Glamorgan. Meehan, E. (1996) “Democracy unbound”, in Meehan, E. (ed.) Reconstituting Politics. Belfast: Democratic Dialogue, pp. 23–40. Moyser, G., Parry, G. et al. (1992) Political Participation and Democracy in Britain. Cambridge: Cambridge University Press. Niskanen, W. (1971) Bureaucracy and Representative Government. Chicago IL: Aldine Atherton. Osborne, D. and Gaebler, T. (1992) Reinventing Government: How the Entrepreneurial Spirit is Transforming the Public Sector. Reading MA: Addison-Wesley. Webler, T., Levine, initials et al. (1991) “The Group Delphi: a novel attempt at reducing uncertainty”, Technological Forecasting and Social Change 39, pp. 253–63.

CHAPTER SIX Public Health Panels: Influence at the Margins? Maggie Mort, Stephen Harrison and Therese Dowswell

Introduction Making health care policy in Britain is an activity which lies somewhere between governance and commerce. The National Health Service (NHS) in the late 1990s is a heterogeneous institution in which elements of paternalism, quasicommercial contracting and participatory democracy coexist. It has become hybrid, subject to different, sometimes contradictory influences and is arguably at the forefront of British experiments with new forms of governance. Since the establishment in 1948 of a wide-ranging welfare state, British citizens could expect their collective welfare to be mediated through local and central government, while their interests as service users would be addressed by market mechanisms. Citizens could enter into limited dialogue with government, while service users, assisted by their limited powers of exit, could enter into dialogue within the marketplace. Health care within the NHS, however, is neither a business nor a form of government. It is a contested field in which equity and social solidarity are cherished, if problematic ancestors, alongside other contested areas such as social and medical meanings of health itself. The principle of equity remains a strong influence over the ethics of provision; the notion of solidarity, where citizens agree to ensure that sufficient resources are made available to provide care free at the point of use, has endured through the waves of marketization which have occurred since 1991. Geographically defined health authorities receive public funds calculated on the size of their resident populations plus their demographic and epidemiological characteristics. Each health authority is then expected to purchase health care for its population from quasi-independent, but publicly owned, NHS trust hospitals and clinics.1 The rationale for this arrangement can be seen as both permitting competition and facilitating health planning (Harrison 1991). Unlike the national health systems of countries such as Sweden, the governance of the NHS has never made much use of locally elected politicians. Although elected local government authorities were originally responsible for community health services, this was abandoned in 1974 in favour of local health authorities composed mainly of central government appointees,

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with additional local government nominees. At the same time as the introduction of quasi-markets in 1991, the membership of health authorities was modified to exclude representatives of elected local government, leaving only the indirect chain of accountability to central government via nominated non-executive directors (Hunter and Harrison 1997). Various attempts have been made to fill this democratic deficit (Wistow 1993), including government support for the practice of drawing users and public into dialogue with the NHS, urged in such official documents as Local Voices (NHS Executive 1992). Ironically, therefore, it is that very marketization and the weakening of democratic accountability resulting from the Conservative government’s 1991 NHS reforms, which has spurred current widespread attempts to increase non-market forms of public consultation in health decision making. Thus, while links with elected, representative forms of government were severed locally, links with community groups and samples of the public were to be strengthened.2 A curious paradox has emerged where the rhetoric and practice of the market, such as contracting for services, is accompanied by exhortations to consult with the public and involve users in decision making. Efforts to involve the public have not all been top-down or centre-led and initiatives have been pursued by a broad coalition of interests. Politicians on the Right, with an ideological interest in health care privatization, and health services managers who believed the market would bring efficiency into what they saw as a bureaucratic, statist body, perceived the NHS organizational changes as creating a consumer culture within which to pursue customerfocused provision. However, pressure groups and those interested in increasing public access and involvement in health saw opportunities within the fragmentation for a shift from weak and unsatisfactory representative democracy to potential participatory democracy within a decentralized health care system. Thus, consultation initiatives of various kinds seem to be flourishing because the actors can reach broad agreement about means, without necessarily agreeing on the ends at which they are directed (Lindblom 1979). Thus the mechanisms of public consultation and user involvement are as open to interpretative flexibility as other (harder) technological systems deconstructed by sociologists of science and technology (Bijker 1987). In this way the creation of dialogues between health authorities, service users and the public has recently become the focus of much innovation in British public policy. There is a wide range of practice, from do-it-yourself initiatives and pilot projects carried out on small budgets, to larger more nationally visible schemes. This chapter describes one major strand of dialogue with the public: the use of health panels initiated by or on behalf of health authorities, and how they might enhance democracy. Though we refer occasionally to other published studies, we draw mainly on our own postal survey and interview-based research conducted within English health authorities, quoting individual re spondents from our study. These respondents include members of our own one-day mini-panel, which observed and participated in a conference about consultation that we

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sponsored. This mini-panel was drawn from an existing large-scale postal panel which had been running in Calderdale and Kirklees, two health authority regions in northern England. The members of the minipanel therefore had previous experience of non-deliberative consultation, whereas the conference examined deliberative and hybrid forms of public panel. Following the conference, these members gave their views about consultation during a group discussion held with the organizers. The full findings are reported in Dowswell (1997). We carried out an examination in 1996 of local efforts to draw the public into health decision making. This showed that a community was being sought out by health authorities which was wider than their existing contacts with service users or carers. These health authorities have come under increasing pressure within limited budgets, to consider not just how or where to purchase, but whether to purchase particular services at all (Harrison and Wistow 1992). This problem of service rationing has become increasingly visible in Britain following a number of high-profile individual cases (Freemantle and Harrison 1993; New 1996) and within the context of serious budget shortfalls. Although health care rationing may have always taken place, it has been implicit and perhaps arbitrary, but there is now increasing pressure, in the market context, to make this process explicit. In the words of one health authority marketing manager, “We need to demystify decisions which are now random”. In the context of rationing and for wider planning issues, then, health authorities have begun to seek ways of involving the general public in the policy process. However, the general public is an ill-defined and rather mysterious entity, and we found that health authorities defined their publics in many different and sometimes contradictory ways. Thus, while some consultative initiatives were clearly designed for taking a snapshot of public opinion, other initiatives sought a more reflective response. What Is a Public Health Panel? We define health panels in terms of two criteria. First, they are initiatives where a group of people are selected to represent their community as a whole, rather than to represent the interests of particular users, carers or single-issue activist groups; that is, they are meant to represent some conception of the general public. Our second criterion was that this public grouping should exist over a period of time, so its views were being sought over a series of contacts or meetings, as a standing panel. In this way the panel has the opportunity to see itself as a group of citizens with a representative role or identity, rather than as a one-off, ad hoc phenomenon. So health panels, as we here define them, are those initiatives where the general public is revisited or consulted over time. Our definition includes a number of more precisely defined consultation mechanisms. Thus we include citizens’ juries within our definition of health panels because they broadly meet our criteria. They involve the general public and are revisited in the sense that the jurors meet over a number of days to consider a specific issue, and

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may also meet in advance of the jury and for follow-up sessions after it has ended. Such juries, run by the Institute of Public Policy Research (IPPR) and three by the King’s Fund during 1996–7, have been high-profile mechanisms for consulting the public in Britain (Coote and Lenahan 1997).3 On similar grounds we have included the series of Somerset health panels (Bowie 1995). Deliberation and Information At least 40 health authorities and community health councils (CHCs)4 were holding or planning to run health panels early in 1996. All had assembled statistically representative groups of citizens, which were being asked in various ways to consider health issues or policy. The following list of examples is simply intended to give a flavour of the different types of standing public panel in locations where expertise was being developed in different methodologies: • Calderdale and Kirklees Health Authority established a talkback panel of about 2,000 members, instigated in 1992. This is a joint health authoritylocal authority postal panel set up to gauge public opinion using three questionnaires per year. Occasional focus groups from the panel are held. Feedback is via regular newsletter to panel members. • Tees Health Authority formed Teesside Talks Back in 1996. Eight panels, each of 16 members, hold face-to-face meetings, with the accent on deliberation and gaining consumer input. The approach is influenced by Somerset methods (see below). • Cambridge and Huntingdon Health Authority held the first British citizens’ jury in March 1996, focusing on rationing, who should be involved and how criteria should be set. The health authority also held in-depth focus groups of the public in 1994 in order to consider criteria for purchasing assisted conception services. • Dumfries and Galloway Health Council has run various panels using different methods. Broad policy issues are covered in an initial questionnaire, followed by information giving, outreach meetings then follow-up questionnaires. Topics have included mental health, dental services and accident and emergency provision. • Newcastle and North Tyneside Health Authority established an experimental project with a postal panel of 820 members receiving an open text questionnaire inviting them to set the agenda for further consultations. This was to be followed up by a number of focus groups drawn from the original panel. • North Tees Community Health Council established a community network of one per cent of the local population together with community group repre sentatives, about 3,500 members in total. The panel has been used to discuss a number of issues, including health service rationing.

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Figure 6.1 Evaluating public health panels.

• Warrington Community Health Council ran its Healthwatch Panel of 600 members from 1993 to 1996. The panel conducted eight major surveys by postal questionnaire, including rationing, mental health, pharmacy and GP services. A newsletter provided feedback to members. • Kensington, Chelsea and Westminster Health Authority in collaboration with the Riverside Mental Health Trust organized two joint citizens’ juries about improving quality of life for mental health service users, carers and their neighbours. A round-table meeting between authority and jurors was held to draw up an action plan, which was to be evaluated within six months. • Somerset Health Authority commissioned a rolling programme of deliberative face-to-face panels of 12 people. Members voted anonymously on three issues per meeting after a discussion had taken place. This was one of the earliest examples of public consultation on such health matters. From our research findings we constructed a matrix (Figure 6.1) to help classify and understand the range of attempts to involve the public in health decisions. This matrix is here used descriptively, and to some extent analytically, in order to show that the many approaches being used can imply four different models of the public, since deliberation and information are analytically independent of each other. Deliberation occurs where members of the panel have the opportunity to discuss and interact with others about the questions under consideration. Deliberation may occur because there is the chance to talk during meetings; this is what happened in the Somerset panels or in focus groups. Deliberation may also occur because there is the chance to enter into dialogue with witnesses; this is what happened in the citizens’ juries. Consultation is described as nondeliberative when the panel members respond as individuals without the op portunity for discussion. Although it is always possible that respondents will discuss questionnaires with friends or relatives, invariably it is assumed that it is the individual’s view alone which is being expressed. Standing public panels such as the Calderdale and Kirklees panel are thus non-deliberative in this sense.

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Panel members are informed when they are provided with some sort of factual, technical or background material about the topic under consideration before being asked to express their opinion. This occurred in the Dumfries and Galloway consultation, where advance briefing papers and meetings were provided. The oral briefings given at the Somerset panels and citizens’ juries also constitute information in this sense. Conversely, where an opinion is sought which relies on members’ instant or preformed attitudes and views, this is termed uninformed. Key Actors Many authorities which were not engaged with standing public panels, expressed strong interest in finding out more about issues and methods related to these initiatives. We found that there was a growing participation movement in the NHS; a more instrumental reading would be that of a consultation industry. Some authorities were actively marketing their consultation methods within the NHS, where a consultation conference and workshop circuit was becoming increasingly popular. It was interesting to note that very few clinicians were involved in public participation work, rather this was the domain of press, public relations and communications people, some of whom had professional titles such as user involvement coordinator or director of communications. These individuals, whom we call participation entrepreneurs, would then find themselves acting as persuaders for public involvement work within their own organization. As one health authority marketing manager put it, “We need to educate the board”. These individuals often find themselves positioned between senior management within the health authority and the general public, acting as conduits of information, keeping both entities enrolled in the consultation process: It comes down to money in the end. Personally I get bored to death with questionnaires. So what I try and say is, What is the best method for this particular piece of work?…It’s a case of squeezing my boss for more money. (Health authority communications manager) Other entrepreneurs in participation come from outside the NHS, namely from research organizations or think-tanks such as the Institute for Public Policy Research and the King’s Fund, whose role in promoting citizens’ juries also had a wider effect of stimulating debate around other forms of innovation. Choosing the Public: Informed or Ignorant? We are asked to talk to the public, but if you ask anybody what the public is they are not sure…. At home when I have my bin emptied I

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regard myself as a member of the public…but not when I am at work. (Health authority communications manager) How does a health authority go about constituting a public health panel? In most cases a random selection is first made from the electoral roll, or possibly the local list of persons registered with general practitioners. A market research agency may well be involved in this process. This random sample is then contacted and people asked whether they are prepared to take part in a public health panel as a volunteer, but usually with a nominal payment offered to cover expenses. Those who agree are then matched to an existing community profile, so the sample can be balanced to account for age, gender, ethnic group, etc. Interestingly, many authorities then usually make another set of exclusions, particularly for the smaller deliberative panels or juries. The most common exclusion is that no health authority employees should serve on the panel, as they are perceived as having vested interests. In practice this has the effect of removing most medical and health care knowledge from the panel. The reason most often given for this is that more informed individuals, such as health service staff, might dominate the discussion. One authority also excluded journalists, as it was felt members of a deliberative panel might be inhibited from contributing to discussions if they knew a journalist was present. Both the large-scale and the smaller deliberative panels, examined as part of this study, also carry out a process of refreshment whereby members serve for a limited number of occasions and are then replaced by new recruits. This is said to avoid professionalization of members of the public. Hence, while a certain amount of learning is permitted, it is not considered advisable for members to become too informed or too familiar with the consultation process, because then they may cease to be genuine members of the public. In this view of the public, while some familiarity with the agenda and process is desirable, at some point an excess of knowledge is perceived to be dysfunctional. These sifting processes take place for the majority of public standing panels in the health field. While the health citizens’ juries have also selected their publics largely in this way, no refreshment of members is required because the jury meets for a predetermined duration, usually four days only, and is not recalled to consider a new issue. Choosing the Method The choice of consultation mechanism interrelates with the types of questions put to the panels. Thus, large-scale postal surveys may lend themselves to broad issues, i.e. those not related to specific services or users. Broad questions tend to be those where it was felt most of the public, irrespective of experience or educational background, would be able to answer without deliberation. Postal questionnaires contain short, quickly and easily answered questions which are

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usually (though not invariably) closed, rather than open-ended. These questions tend to test the public’s prior understanding of health or health issues: The questionnaire…is only really useful if it’s very broad issues that people, anyone—as a member of the general public or a citizen or whatever you want to call them—can have a view on. We try not to allow it to get too specialized They don’t get a lot of information. (Health authority communications director) Where the public is being asked to consider questions requiring special information, or where they would need to deliberate over complex issues (such as how and where to provide continuing care of the elderly), small panels or citizens’ juries tend to be used, in order to give a more informed view: We wanted to get a so-called more informed public in that we wanted to be able to give them information and actually hear them discussing it rather than just sending out say a questionnaire where they are never quite sure… why a person gives a certain answer. (Health authority marketing manager) While both approaches to consultation construct representative samples of the general public and both allow that public to revisit issues and experience a degree of learning from being members of a panel, the differences in method mean that they are nevertheless likely to yield very different outcomes. Cost constraints will also influence the choice of method and threaten to consign public consultation to the margins of local purchasers’ thinking. While the set-up costs of large-scale survey panels tend to be relatively high, up to £20, 000, the ongoing costs per survey are lower, about £2,000, once the sample and mechanism is in place. Small panel projects, such as revisited focus groups, where there is some information and deliberation can be run for about £2,000, but rolling representative groups such as the Somerset panels require about £40,000 per year. Citizens’ juries have averaged at around £16,000 each and have so far been funded by grants and sponsorship. Given these relatively high costs, it is not yet known whether health authorities will themselves be prepared to finance juries in the future. Given that cost may prohibit choice in some areas and that evaluation of different methods is incomplete, most health authorities are not clear which method of consultation they should adopt. It seems that practice is likely to continue in an ad hoc, pragmatic way with costs also having some bearing on how the resulting information is used by the authority. Different interest groups within the NHS may be looking for different outcomes from panels and juries. Remember that the method of inquiry has a strong bearing on its outcome; and while this may be well known in sociology (Cicourel 1964), it may not be well understood by the consultation community within the NHS, where market

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research methodologies, increasingly qualitative in structure, coexist with traditionally quantitative, scientific approaches, e.g. in epidemiology. Public preference about which means of consultation is chosen is very poorly researched, but there is some evidence that panel members prefer to be involved in deliberative rather than non-deliberative consultations. One Somerset panel member described the process of moving from initial reactions to topics, through discussion, to a more informed view: “Much better than if you were to stop and ask someone in the street” (Bowie 1995). Some of the views expressed by members of the Kensington, Chelsea and Westminster citizens’ jury were recorded on tape for future training purposes. These indicated a high level of commitment to participation: People need to have a say, they don’t in politics and local authorities…. I hope we can come up with something which will really benefit society. This was also apparent in our own study, where all the panel members said they preferred to discuss questions in a group before making responses. It was good to have the group discussions. It broadened knowledge. I didn’t know some of the stuff that was going on. The better informed process is better than a questionnaire. I’d rather have open-ended questions, or room on a questionnaire to think what I was going to write. (Public panel members) Deliberation also fostered a sense of thinking collectively for and on behalf of the community, rather than for individual interests: “When faced with an individual interviewer, people are more likely to consider their own personal interest on an issue. It is clear from the discussions that panel members made the conceptual leap to the common concern” (Bowie 1995). It was suggested in our study that being a regular panel member also had a similar effect: No I don’t think about my interests. I know money is limited, so I think about the area as a whole. No one thinks from just a personal point of view. There are cultural influences, there are lots of things. (Public panel member) There is overwhelming evidence from all the forms of deliberative panel held so far that they have been popular, if frustrating, exercises for those taking part in them. What is not evident is whether this form of consultation would be endorsed by the wider, largely unconsulted public. This is an issue that we return to towards the end of the chapter.

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Questions Put to the Panels There is certainly evidence that the method of consultation both limits and defines the sorts of question that are put to health panels. Difficult health rationing questions are not put to large-scale postal panels, even though they tend to enjoy higher status as representative because of the sheer numbers involved. Bradford Health Authority has one of the largest panels at 2,500 members, but has not so far tackled difficult or complex questions. More problematic issues, such as care of the dying or whether to purchase routine treatment outside the region in order to reduce waiting lists, are usually put to citizens’ juries or deliberative panels, even though their representative status is perceived to be lower due to the smaller numbers involved, 8 to 16 people on average. In most cases it is the commissioning authority which sets the agenda for the panel because it is commonly agreed that there would be little point in panels and juries spending time deliberating questions which were not of immediate concern to the purchasers of health care. To date there have also been very few instances of panels themselves being asked to set the agenda, the most notable exception being in Newcastle, where the public was first asked to indicate its most urgent concerns. Interestingly, this panel emphasized waiting lists and bed closures as the most important issues for them, in marked contrast with the priorities later identified by clinicians and management. There was a sense of frustration among some participation entrepreneurs that difficult issues were not often tackled: I think we were quite soft-footed to start with about the sort of questions we were asking. But if this panel is there to be used, it is there to be asked questions that are difficult and controversial, so why aren’t we asking them? …All the agencies have shied away from asking really controversial things…the political sort of thing, we are not going to ask anything that, you know, sacks the whole lot of you or whatever. Personally I think we should ask questions like that because I think the public needs to know the kind of choices that are made. (Health authority communications manager) Do Health Panels Make a Difference? In no case have we found any firm commitment given in advance by health authorities to abide by the findings or recommendations of panels. Most panels are asked to give advice rather than to make a decision, and great care is taken by the authorities not to commit themselves to taking action based solely on the results of the consultations. This is usually said to be because the views of the public must, at a later stage, be balanced with other views: But I mean the public voice is just one voice amongst many, particularly as I have said, the GP/clinician voices and also the views of the CHCs,

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voluntary bodies, social services or whatever. (Health authority marketing officer) I mean the main problem is that public consultation is only one part of the jigsaw and how important that part is in relation to the GP part or the trust part or whatever. What we have to ensure is that public consultation is an equal part of the jigsaw and not an inferior part or even, you know, a major part of it. (Health authority communications officer) The question this raises is, why go to the considerable trouble of obtaining a representative sample of the public in the first place? The public is here constructed as just another interest group to be balanced with doctors, managers, etc. And implicit within this construction is the view that the public is also seen as not being wholly competent to make decisions. What they [the citizens’ jury] offer is a very well-informed, welldocumented, well-structured viewpoint that has been well informed and taken time, can be evaluated…. It’s a very very robust form of public involvement. So it should be, at the price, but it is one public involvement. The professional voice and the public voice have to be balanced. I think they do have equal weight but ultimately the decision about what is done will always be taken by the board. (Health authority communications officer) In contrast with legal juries, the outcome of the representative public panel, or the British health citizens’ juries, comes to be seen as only a partial view, rather than the whole view. While in the legal process the jury’s decision in court is taken to be authoritative and paramount, the citizens’ jury’s findings must be qualified or even marginalized. Where the legal jury is the voice, the citizens’ jury is only one voice. This pluralist construction of the public as partial and not wholly competent has come about partly because of a fear that there might be mistakes or bad decisions, such as the failure to protect minority or unpopular groups, but it also follows partly, we argue, from the exclusions earlier imposed upon the panel selection. For example, if medical practitioners are excluded from a public health panel, it follows that the medical view is absent and must therefore be sought out later, in order to provide balance. Equally the public voice has to be balanced against the service users’ voice, so the public view becomes partial. While we found no advance undertakings given by authorities to take account of the results of health panels, commitment to act on the panel’s findings appeared strongest (if equivocal) within the citizens’ jury model. In this case an undertaking is given at the outset, at least to give the reasons why an authority may not act in accordance with the jury’s findings, but this commitment is still relatively weak. In most other cases the authority simply agrees to take account of the findings. Yet most panel members do take an interest in the findings and this weak commitment has raised some concerns:

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I have never read that the health authority have taken any action. We just get “70% said this, 30% that”. It’s up to them to show it is transparent and honest. You need a success story. (Members of a public panel) Credibility While the intentions of the authorities and the participation entrepreneurs may be sincere and laudable, the crucial point remains that panels and juries have to be credible (Stewart 1994). This is unlikely to be the case if both the participants and the wider public come to perceive them as talking shops. This feeling may be reinforced not merely by their advisory status, but by the finding that, to date, panel findings have tended to be very generalized and almost completely uncontroversial. Examples of such findings include (a) there should be a national advisory body to set down broad criteria for rationing but local people should still be consulted on this; (b) equity of access should be preserved, but so should doctors’ discretion on individual cases; (c) services should be locally accessible but choice to travel for treatment should be available; (d) care should be better integrated and coordinated. Where the results of consultations do not pose a challenge to authorities, it is impossible to conclude that the public has been influential. Yet the authorities accrue legitimacy from having undertaken (increasingly sophisticated) ways of consulting the public. In addition to this, feedback of information, especially to the larger panels, was generally poor and many consultation mechanisms appeared more like a permanent pilot exercise in which there was a greater interest in examining the process than the outcome: …explore, or let’s say evaluate, to what extent does this way of consulting the public contribute to the thinking and decision-making process in the health authority…exploring the process, methodological issues, rather than issues of particular importance that they wanted to discuss. (Consultant in public health) Who then is competent to make decisions? A number of different problems were raised by health professionals about the public’s ability to make decisions: the public could only make recommendations and could not force decisions; the public have no legal responsibility to make decisions; it is not appropriate for paid decision makers to pass the buck over difficult questions; the public do not have the skills or enough information to make decisions; the public should only influence broad policy rather than specific resource allocation; the public view must be weighed against that of other stakeholders. We were also puzzled by the apparent absence of conflict around health panels. Does consulting a health panel act to filter out controversy? If health panels are a pluralist manifestation of democracy, we would expect to find some

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examples of struggle and compromise. Perhaps closer, ethnographic research would uncover instances where panel members or authorities were challenged during the course of the consultation. Perhaps as has been observed in social studies of science and medicine, the uncertainties become occluded or blackboxed (Singleton and Michael 1993). Somehow controversies get dissolved in the bureaucratic processes of conducting the panel, writing the reports, feeding back information, and so on. Are we perhaps seeing the building of new social technologies designed to influence human behaviour (Ashmore 1989) by incorporating the public? Conclusion Being in favour of better public consultation is rather like being against sin; it is hard to find any real dissent, something which we also found in our earlier research into service user groups (Harrison 1997). In terms of the public involvement matrix which informs this book, public health panels are purportedly classifiable in the collective/holistic cell of the matrix, in that they claim to seek a public view about the allocation of health care goods across a population. But, as we have noted, agreement about means may be easier to secure than agreement about ends, and it is perhaps not surprising that we encountered little discussion about the fundamental purposes of health panels. Such purposes might well be contested, and could comprise any of the following: 1. To obtain knowledge or information where the consultees might be expected to know more than the decision maker. 2. To ascertain whether consultees have different, and presumably more authoritative, values from the decision maker. 3. To legitimate decisions made (or to be made) by the decision maker, either by incorporating the consultees and/or claiming that the due process of consultation is sufficient legitimation in itself (Young 1996). 4. To provide a process of participation for consultees which is of value for its own sake, e.g. education for citizenship. The conduct of the various kinds of health panel that we have described makes it clear that item 1 is not the case; panel members were either selected for their ignorance and/or were provided with information as part of the exercise. The prevailing wisdom that health authorities should make the final decisions, together with our difficulty in establishing cases where the consultation process clearly made a difference to the outcome, cast doubt on item 2. So there is room for suspicion over item 3. We come to item 4 later on. It seems clear that the panels that we have reported are not designed to be exercises in direct democracy. Rather, they are designed as an adjunct to a system of representative

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democracy which, as we noted in our introduction, has become very much attenuated where health policy is concerned. However, panels certainly enhance participation, learning, experience and competence on the part of the public and the health professionals involved. Interestingly, as in the case of citizens’ juries, the participants may actually acquire much deeper knowledge than those with the power to make decisions: I doubt whether many, you know, health authority members and all the rest, ever think about a topic for four days and hear different views. We aren’t necessarily doing this for people that are actually making, you know, charged with making the decisions. (Health authority director). The educative function that panels serve may go beyond the substantive question at stake, however, and enhance the general sense of political competence or efficacy held by the participants. This has been a central concern of theories of participatory democracy since the eighteenth century (Pateman 1970); a priori it seems particularly likely that those panels which involve both information and deliberation (Figure 6.1) would enhance active citizenship more generally. Whether this is so would need to be established empirically, but it is relevant that although some surveys of public opinion about who should make health care rationing decisions exhibit substantial public reluctance to be involved (Heginbotham 1991; Bowling 1993; Bowling 1996), participants in the Somerset health panels (see above) express perceptions of increased competence when they reach the culmination of the panel process (Bowie 1995). We do not know where this will lead, but it may enhance the ability of citizens to join in networks of users (Fox and Miller 1995), or even new social movements (Dalton 1990) in order to influence public policy. Of course, such activism is not uncontroversial; as Rhodes (1996) has argued, the development of governance by network is private government which may exclude many social groups by the creation of new oligarchies. However, the fragmentation of governance opens up creative possibilities and alliances which we are invited to engage with (Rose 1996). The arguments for a more participative democracy are cogent (Mather 1995), and the kind of gains that we have identified are only the most modest step on the road it. Health panels certainly show they have an important function in informing, educating, influencing, even in improving accountability, but not so far in changing, determining or shaping policy. Their role in policy is unlikely to be strengthened unless the workings of panels can be resourced over time, instead of depending on research grants or squeezing the boss for money. For panels to be capable of enhancing democracy, there needs to be a traceable pathway between public consultation and governance. This may follow if there is commitment to an agreed way for the public voice to move from the margins to the centre of policy-making. Would the public, if asked, endorse the use of health panels as an established tool in the apparatus of democracy? Would the positive

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and supportive views widely expressed by panel members translate into wider public support for this kind of participation and how would such a translation come about? Notes 1. General Practice Fundholders may also act as purchasers, but we do not deal with them in this chapter. In May 1997 the Conservative government responsible for the new NHS structure was displaced by a Labour government, which in general terms is committed to retaining some form of purchaser/provider split, but with less emphasis on competition. 2. Advocates of such developments often fail to distinguish between the public in the capacity of service users and a more general citizenry. In this chapter we are concerned with the general citizenry; for recent research on user groups, see Harrison (1997). 3. Often described as “think tanks”, these two organizations are registered charities funded by research grants and (in the case of IPPR) sponsorship from industry. Both carry out and publish research; the work of the Kings’ Fund is directed particularly at health services, whereas IPPR covers social, political and economic aspects of public policy. 4. Community health councils are autonomous bodies set up under statute, funded by government and made up of nominated members from voluntary organizations and local authorities. Community health councils have a remit to represent both service users and the local community with respect to the provision of local NHS services.

References Ashmore, M. (1989) Health and Efficiency: A Sociology of Health Economics. Milton Keynes: Open University Press. Bijker, W. (1987) The Social Construction of Technological Systems: New Directions in the Sociology and History of Technology. Cambridge MA: MIT Press. Bowie, C. (1995) “Consulting the public about health service priorities”, British Medical Journal, no. 7032, 311, pp. 1155–8. Bowling, A. (1993) “Explorations in consultation of the public and health professionals on priority setting in an Inner London health district”, British Medical Journal, no. 7032, pp. 851–57. Bowling, A. (1996) “Health care rationing: the public’s debaten”, British Medical Journal, 312, pp. 670–74. Cicourel, A. (1964) Method and Measurement in Sociology. New York: Free Press. Coote, A. and Lenahan, C. (1997) Citizens Juries. London: Institute for Public Policy Research. Dalton, R.J. (1990) Challenging the Political Order: New Social and Political Movements in Western Democracies. Cambridge: Polity Press. Dowswell, T. (1997) Health Panels—A Survey: Final Report of a Research Project for the NHS Executive. Northern and Yorkshire Region Project HSR 015.

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Fox, C.J. and Miller, H.T. (1995) Postmodern Public Administration: Towards Discourse. London: Sage. Freemantle, N. and Harrison, S. (1993) “Interleukin 2: the public and professional face of rationing in the NHS”, Critical Social Policy, 13, 3, pp. 94–117. Harrison, S. (1991) “Working the markets: purchaser/provider separation in English health care”, International Journal of Health Services, 21, 4, pp. 625–35. Harrison, S. (1997) “High praise and damnation: mental health user groups and the construction of organisational legitimacy”, Public Policy and Administration, 12,2, pp. 4–16. Harrison, S. and Wistow, G. (1992) “The purchaser/provider split in English health care: towards explicit rationing?”, Policy and Politics, 20, pp. 123–30. Heginbotham, C. (1991) Health Care Priority Setting: A Survey of Doctors, Managers and the General Public. London: BMJ Publishing. Hunter, D.J. and Harrison, S. (1997) “Democracy, accountability and consumerism”, in Monroe, J. and Lliffe, S. (eds) Health Choices: Options for Health Policy. London: Lawrence & Wishart, pp. 120–54. Lindblom, C. (1979) “Still muddling, not yet through”, Public Administration Review, 39, 6, pp. 517–26. Mather, J. (1995) “What are the democratic impediments to participatory democracy?”, Politics, 15, 3, pp. 175–82. New, B. (1996) “The rationing agenda in the NHS”, British Medical Journal, 312, pp. 1593–601. NHS Executive (1992) Local Voices: The Views of Local People in Purchasing for Health. London: NHS Executive. Pateman, C. (1970) Participation and Democratic Theory. Cambridge: Cambridge University Press. Rhodes, R.A.W. (1996) “The new governance: governing without government”, Political Studies, 44, 4, pp. 652–67. Rose, N. (1996) “The death of the social? Re-figuring the territory of government”, Economy and Society, 25, 3, pp. 327–56. Singleton, V. and Michael, M. (1993) “Actor networks and ambivalence: general practitioners in the cervical screening programme”, Social Studies of Science, 23, pp. 227–64. Stewart, J. (1994) Citizens’ Juries. London: Institute for Public Policy Research. Wistow, G. (1993) “Democratic deficit”, Community Care, 129, p. 29. Young, S. (1996) Promoting Participation and Community-based Partnerships in the Context of Local Agenda 21: A Report for Practitioners. Manchester: University of Manchester, Department of Government.

CHAPTER SEVEN Promoting Consumer Choice: Child Day-Care Vouchers in Finland Pekka Kettunen

Introduction The Scandinavian nations have become universally known for the comprehensive social benefits provided for their citizens and the use of redistributive fiscal policies, which have sought to guarantee a minimum standard of living for all (Milner 1994; Rothstein 1994). During the last 40 years, Finland has been an enthusiastic proponent of this form of social democracy, constructing an extensive welfare state, which has provided a wide variety of social, health and educational services, predominantly through the use of publicly owned and managed bodies (Kangas 1994). Where Finland has historically differed from its Scandinavian neighbours, has been with respect to the delivery of public services. Unlike in Norway, Sweden and Denmark, where regional government has tended to take a more prominent role, particularly with respect to the provision of social and health care, the Finnish model has predominantly been a local one (Salminen 1991). Nevertheless, up until the late 1980s it was possible to talk in broad terms about a distinct Scandinavian model of welfare provision that provided a broader and more generous range of welfare and social services than any other region in northern Europe. Yet by the early 1990s, much of this legacy appeared to be under threat across Scandinavia, especially in Finland itself. Economic recession, which had swept across northern Europe in the waves since the mid-1970s, had its greatest impact in Finland, partly because of the break-up in 1991 of its economically important neighbour, the Soviet Union. Finland’s foreign debt began to mount as economic growth came to a rapid halt. Unemployment reached a record 18.4 per cent in 1994, which in turn affected public sector tax revenues (Rothwell and Pollitt 1997). The impact on the Finnish welfare state was marked. Not only was there increasing pressure on the Finnish government to rein back its redistributive fiscal politics, but between 1991 and 1995, state subsidies to local government were significantly reduced, which consequently obliged local authorities to undertake a variety of retrenchment policies. Although it would be inaccurate to talk about the collapse of the post-war welfare state in Finland, economic recession since 1991 did force both central and local government to reduce their

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own commitment to the welfare state, and in doing so, transfer a degree of responsibility for individual welfare provision onto the citizens themselves. Yet the challenge to the hegemony of the Finnish welfare state cannot be explained in economic terms alone. The decline of the post-war welfare state also relates, at least in part, to a somewhat less precise argument over the collective values of Finnish society at large. This argument holds that the Finnish public as both citizens and service users have become markedly less committed to government, politics, the welfare state and the principle of collective provision. Writers such as Rothstein (1994) have argued that the legitimacy of the modern Scandinavian welfare state had in fact been under threat prior to the reform movement of the 1990s; and in support of their argument, they point to lower voter turnouts, widespread criticism of politics, as well as a rise in individualism. The broader political traditions are a further complicating factor that needs to be considered in the Finnish case. Firstly, the 452 local authorities in Finland which make up the backbone of the welfare state represent a politically heterogeneous though predominantly rural tradition, which brings a consensual and stabilizing element to the Finnish political system (Milner 1994). At a national level too, ideological politics has played less of a role in Finland than in Sweden or Denmark, or more particularly countries such as Britain. Government in Finland has traditionally been based around political coalitions, hence the reform movement of the last decade has been characterized in terms of a unique interpenetration of bureaucratic legalism and political consensus, as expressed by Rothwell and Pollitt (1997). Although the developments discussed in this chapter took place under a Centre Right government from 1991 to 1995 and a Conservative-Social Democrat coalition from 1995 onwards, seen as a whole, the reforms of the 1990s reflected a widely held belief in the need to re-evaluate the fundamental principles upon which the Finnish welfare state had been built. The reform movement in Finnish public policy is best characterized by the principle of decentralization. Historically, welfare policy had been determined by central government, where local authorities would be persuaded to implement reforms through the provision of special state subsidies. Since the late 1980s, however, Finnish local authorities have been given greater scope for discretion (Oulasvirta 1995). This commitment to a decentralized reform structure first became evident in the free-commune experiment of the late 1980s, where local authorities were given greater autonomy to devise their own systems for local service provision (Baldersheim and Ståhlberg 1991). This autonomy was then further strengthened by the state subsidy reform of 1993 and the New Local Government Act of 1995; the 1995 act encouraged local authorities to adapt their service delivery structures so as to better suit the needs of their particular community. When seen as a whole, the effect of each of these individual measures has been a gradual, yet firm diffusion of responsibility for both the provision and the organization of welfare services, from the centre to the locality.

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Given that such a programme of decentralized reform has taken place against a backdrop of fiscal restraint and public disquiet, it is of little surprise to find market methods being applied to a number of issues relating to the delivery of local services. With this movement have come market-oriented buzzwords such as responsiveness, efficiency and competition, where the rights of the service user as customer have been placed in the ascendant. The aim of this chapter is to focus on the idea of the customer and in particular the pros and cons of introducing greater choice within the public sector. This will be done with particular reference to a recent pilot project which sought to test the benefits of introducing a system of vouchers for the provision of childcare. Within the scope provided by a volume such as this, the aim will be to establish whether greater user choice can and should be viewed as part of the wider movement to empower communities. Consumerism and the Welfare Reform Movement It is not immediately obvious why consumerism should play a significant role in the development of Finnish welfare services. During the first stages of the reform movement it did not. A majority of the western European retrenchment programmes of the early 1990s focused on intra-organizational measures that left the role of citizens untouched or even reduced (Walsh 1995). Consumerism only began to be considered in the later stages of the reform movement, challenging as it did many of the fundamental principles of collective welfare provision. Public vs Private: A Traditional View The traditional arguments against the introduction of consumerism in the public sector have been well rehearsed. They centre around the assertion that the public sector produces goods and services which are distinct in nature from those provided by the private sector, that the public sector provides these services within a unique setting, and that as a consequence, the introduction of market mechanisms can and will lead to inappropriate and unjust social outcomes. The first of these arguments contends that many public services have characteristics which make it difficult to apply market principles. Making a contract implies that a municipal authority knows what service users want and that the quality of the end product can be assessed (Pollitt 1995). Related to this is the contention that it is often difficult, if not impossible, to define in advance the nature of public goods such as health, education or rehabilitation (Walsh 1995). Consequently, decision makers need to rely on professional judgements and, through various procedural constraints, aim to control the comparability of services with the original political aims. However, this argument implies that in cases where a public good is not a complicated one, public authorities would be able to make contracts with extraneous producers. Given this is now the case with a number of service areas, including those in the health

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and social sectors, one may ask whether the dividing line between public goods which are difficult to define and private goods which are not, is dependent upon interpretation rather than any intrinsic characteristics. A related criticism is that choice may not be a viable option if there are no alternative producers available; but this also fails to acknowledge that alternative producers can additionally be encouraged to establish themselves. A second criticism of the market model centres on the idea that a central characteristic of the competitive market is the ability for individuals to opt out from one service provider and transfer to another. Parsons (1995) argues that the capacity to opt out of a publicly provided service in order to transfer to a private provider, is limited by financial resources and socio-economic status. He further argues that the whole concept of consumerism fails to understand the particular character of public service production. Burns et al. (1994) argue that the less well-off will be given the illusion of choice when, in the majority of situations, there is not really any choice at all. Similarly, Johnson (1987) claims that there is every reason to believe that a purely private market system would result in greater inequalities. This assertion is supported by Henig (1994), who found that consumer choice within the American school system has historically been used for the purpose of segregation. A final and potentially more telling criticism of the marketization of public service provision relates to the relationship between service users as customers and service users as citizens. Parsons (1995) argues that citizens could become less like consumers and more like co-producers of public policy. This argument is based on the fact that the citizen, unlike the consumer, is both a producer and consumer. Parsons (1995) further claims that managerial controls associated with the marketization of public service provision will in time erode the state itself, eventually destroying the very foundations of political systems which have provided liberty for generations. Finally, it is argued that the concept of the consumer is rooted in individualistic, even selfish behaviour, which contributes little to debates about the needs and concerns of the whole community, particularly where they relate to promoting social justice (Burns et al. 1994). Moreover, as Henig (1994) argues, public services such as education have a role to play in shaping minds and values, so they should not be allowed simply to reflect consumer demand. Consumerism: A Reconsideration Strictly speaking, the ability to consume dictates that a public good becomes a commodity. But we can also regard consumption as a way of helping service users to contribute to the formation of service production structures within a community. In other words, although service users may not directly pay for a service, which is financed through taxation, consumerism in the form of choice can be used to reflect the composition of individual preferences. In this sense, consumerism refers to using the exit option outlined in Chapter 2 as a means of

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aiding service development. In the following section I will examine this issue in greater depth. One of the most important documents to consider freedom of choice in the Scandinavian public sector was a Swedish government report published in 1994 (Anon 1994). It supported the principle of competition and gave several reasons why. It argued that choice provides a counterweight to public bureaucracies; choice makes services more effective, improves their quality and brings more flexibility to their delivery. Of these four issues, the first two could be achieved by introducing competition between service providers or by introducing some form of service monitoring. However, it is the third and perhaps the fourth factors which rely on citizens acting as consumers of public services, expressing their preferences and consuming the products or services that they rank highest. Exercising such choice does not necessarily require additional financial resources from the citizens themselves; they can either make a choice between one hospital or school and another or, as the following discussion illuminates, public authorities can financially support the ability of citizens to act as consumers. With public authority support, the citizen is given what may be termed real purchasing power, in that the transaction which takes place resembles most closely an act of economic exchange. Within this model, it is the payment which brings about the right to express demands from the service producers and which forms the basis of the consumer possessing rights. If consumer choice can be justified in service terms, what then of the contention that it can never become a political form of participation? Without accepting the libertarian view which argues “the less politics the more democracy” (Rothstein 1994), I shall try to argue that in some cases the political and the individual may be combined in the development of public policy. The first issue which critics tend to bypass is the fact that there is a growing dissatisfaction with many public services, and providing citizens with alternatives presents an effective means of measuring such dissent. The use of the exit option can in other words be seen to supplement traditional forms of political voice, rather than undermine them. This assertion is based on the premise that, within the context of public service provision, exit can offer service users a type of input which is not available through the provision of voice mechanisms. And this premise is in turn based on the idea that, within the public policy process as a whole, there are both general and specific decisions which need to be taken. To illuminate the difference, public policy can be said to deal with access, funding and standards. Access looks at questions such as who is entitled to benefit from a particular policy. Funding looks at questions such as whether the service provided is to be charged for at the point of use. And standards looks at questions such as whether doctors should prescribe alternative medicines. These decisions form the framework within which individual citizens express their preferences and new service providers institutionalize these preferences. In cases where similar rules of access and similar charges are applied to the alternative service providers, it seems ungrounded to talk about freedom of

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choice eroding public policy-making. However, it is the issue of service standards which makes the greatest difference, in that while one could imagine users choosing between several identical schools or nurseries, in practice user choice is based on substantial variance and further encourages that variance. As Rothstein (1994) convincingly shows, Swedish maternity clinics only made necessary innovations when competition was forced upon them by mothers who were able to choose between clinics. The point is that by offering freedom of choice, municipal authorities are pressured into reacting to people’s preferences, and as Rothstein (1994) puts it, legitimacy in the present time needs to be earned through being more responsive to citizens’ views. But even though service reform is being achieved through the provision of voice mechanisms, such as user groups, and through the development of professional practice, it can only be guaranteed by having alternative service providers. And while one can imagine a situation where this would lead to public services being divided into municipal services for the poor and private services for the wealthy, it could be argued that as long as one does not identify separate groups who need help, but treats social institutions as being in principle open to all, then variance can and should be allowed. Standardized public goods do not reflect the heterogeneous character of society because needs and preferences vary. Basing public service production on uniform standards implies the prescriptive and paternalistic treatment of citizens. The central question is who should determine the characteristics of public service production. As modern societies become more complicated, the question arises as to whether public policy-making should be determined by political decision makers, service professionals, trade unions and other producer interest groups, or whether user involvement through the mechanism of choice can and should be brought into the policy equation (Salminen 1991; Rothstein 1994). Consumerism and the Voucher System If it is decided that citizens should be able to affect public policy through the use of an exit option, then the challenge for the policy community will be to arrive at a balance between the need to facilitate such choices within a market situation and the need to provide modes of service delivery which are at the same time broadly equitable. Vouchers may represent such a method. In the voucher system, analyzed in more depth in the second half of this chapter, local authorities were able to make the initial decision as to whether alternative forms of service provision were needed. Furthermore, local politicians decided on the value of vouchers and in what circumstances the vouchers could be used. These political decisions, which in principle should have reflected actual service needs, were then complemented by the decisions of the service users themselves, who through their own actions were able to demonstrate whether the services that were available in the public sector met their demands. The principle behind this process holds that wherever the state is failing to provide the required type or

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level of service, a citizen will be able to withdraw from the municipal service provider in order to take up a service from a private provider, or sometimes an alternative municipal provider. The role of the voucher in this situation is to help create a market situation while maintaining a degree of equity in relation to a citizen’s ability to choose between a range of service providers. On a trial basis, this voucher scheme has been introduced into the provision of Finnish childcare services. But before considering it in detail, I will place it in the wider context of the country’s welfare reform movement. Consumerism in the Finnish Welfare Reform Movement For the whole of the 1990s, the Finnish welfare state has been under significant pressure to reform itself. Overall privatization has not been a characteristic of the Finnish reforms; the emphasis has been on new public management and its associated aim to make public services more effective (Pollitt et al. 1997; Rothwell and Pollitt 1997; Klausen and Ståhlberg 1998). The consequence of this drive for greater public service efficiency has been that while central government has not been able to directly intervene in the organization of local government, a general atmosphere has been created where the onus has been on local government itself to find new ways of improving and streamlining the services it provides. Within such a reform movement, it has not been easy to establish how far the citizens of Finland have been able to exercise freedom of choice in the provision of municipal services. Perhaps a brief description of local service provision will help to clarify the situation. There are three major fields of responsibility with the Finnish welfare state: education, social welfare and health. Together they consume up to 70 per cent of the average budget for each Finnish municipal government. Within each of these fields, services are provided almost wholly on the basis of professional judgement, with little if any lay or user involvement. But outside these fields, there has been far greater capacity for flexibility. Within culture and leisure services, for example, municipalities have increasingly provided support and encouragement to local associations and individuals so they become involved as both users and providers of services (Kettunen 1998). One area of municipal provision where increased consumer choice has been introduced is the field of education, where parents have been given the ability in certain circumstances to select a school for their child other than the local state school. It is increasingly common for local authorities to allow parents to choose between schools within the authority’s borders. The result has been the development of schools with particular specialisms such as music or languages. Yet in practice, a safe route to school and classmates from the neighbourhood have remained the dominant factors affecting parental choice. Education also illustrates the limitations of marketization reforms in Finland. For instance, a municipality may refuse to cover the additional transportation costs

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if a child does not attend the school which is closest to home. Similarly, most choices take place within the public system. Where a private service provider is chosen over a municipal one, local authorities may require parents to pay the cost difference between the two. A similar model applies with respect to health care. Finnish local government has enjoyed a significant level of autonomy with respect to whether or not to introduce greater choice into local services. The piecemeal approach to reform, where some local authorities have adopted quite radical consumerist strategies while others have continued to pursue a more traditional and paternalistic path, has led Rothwell and Pollitt (1997) to conclude that the development strategy of Finnish local government as a whole lies halfway along the continuum between a service orientation and a full client orientation. One consequence of this pluralism has been the often quite difficult process of separating out the real motives for reform from the political rhetoric. Nevertheless, it seems there are two broad reasons why greater levels of choice have been introduced into Finnish municipal service provision. Firstly, it is clear that increased choice partly reflects the presence of a more articulate and assertive citizenry. Secondly, it has often been the case that alternative services have presented a cost-effective option for local authorities. Yet when viewed as a totality, the findings from both general evaluations (Pollitt et al. 1997; Klausen and Ståhlberg 1998) and more specific case studies (Simonen 1995; Kettunen 1998) on recent developments in Finnish public policy reform, all point in the same direction: the Finnish welfare system is subject to a comprehensive search for new ways of producing, developing and managing welfare services. Within the Scandinavian countries as a whole, it is probably accurate to argue that both Sweden and Finland have been in the forefront of applying market methods, while Denmark has tended to focus on enabling greater voice and Norway has continued to rely more heavily on relatively traditional forms of public service provision. Childcare Vouchers: A Case Study of Consumer Reform Child and maternity care comprise one of the central pillars of the Finnish welfare state and day care in Finland has been a highly regulated element of public policy for a number of decades. Finland was the first Scandinavian country to start paying child benefits for every child from birth until age 18, and fewer than 15 per cent of all pre-school children are not covered by the public day-care system. This situation provides an interesting comparison to the British model, where the lack of public day care has been viewed as a deliberate attempt by government to put the responsibility for young children on to the parents and voluntary bodies (Randall 1995). The principal forms of day care supported by the Finnish state are as follows. The first provides financial support for parents to care for their child at home. The level at which this support has been given has been the subject of constant public

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debate, with higher sums being paid by local authorities who need to relieve the pressure on municipal nurseries. A second option for parents is to employ a person to look after the child at home or to take a place in a private nursery. This option is quite unusual in Finland. The third and by far the most common option is to use municipal nurseries and childminders. The Child Day Care Act, which came into force in 1973, gives municipalities a general responsibility for the day care of children under the age of 4. In 1996 this municipal responsibility was widened to include all children under school age (7 years), with parents given the legal right to demand a day-care place for their child. Public day-care services had historically been plagued with regional imbalances, where supply and demand for places have failed to be reconciled. One national study, conducted in the mid-1990s, found there to be an oversupply that equated to 7,100 day-care places in one region, while at the same time there were 2,800 places too few in another (Päivähoitopalvelut 1995). Such imbalances were exacerbated by the introduction of the 1996 act, with significant numbers of local authorities finding they were unable to provide sufficient day-care places in municipal nurseries. The costs of municipal day care are divided so that parents pay approximately 12 per cent of the total costs of nurseries, with fees being related to parental incomes. Parents pay similar fees for the municipal childminder places, although they are cheaper for the municipality to provide. From the parents’ viewpoint, the question of day care may be straightforward: either one parent stays home and looks after the children, or both parents go to work and use municipal day care. The number of options available to parents will depend on where they live and whether alternative forms of day care have been established. Whereas rural municipalities may offer only the basic service, larger municipalities will offer municipal nurseries and child minders, private nurseries, half-day playgroups, and the like. For some parents, day-care has been a value issue, most commonly where home care is preferred. For the municipality, this form of day care incurs lower costs than nursery care (Päivähoitopalvelut 1995). However, during the last decade there has been a shift from childminders to nurseries, which has in turn affected the balance between supply and demand. It is partly this change in the patterns of demand for childcare that led the Finnish government to introduce a pilot study examining whether the provision of vouchers would help to reconcile supply and demand problems while simultaneously enabling greater user choice at a lower overall unit cost. The Background to the Voucher Scheme The voucher scheme for day care was introduced by the Ministry of Social Affairs and Health for a two-year trial period. All 452 Finnish municipalities were encouraged to participate, although only 33 did so, partly reflecting the fact that excess supply or excess demand only affected a minority of local authorities.

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The two-year project began in March 1995, with the 33 participating municipalities representing a broad cross-section based on size, type and political composition. The formal aim of the trial was to establish the effect of organizational change on day care, and in particular to see if the voucher system could bring about a decrease in day-care costs by facilitating the development and streamlining of the service structure. Local authorities were encouraged to innovate within these broad parameters, for the government considered such innovations would enhance the value and scope of the experiment. The Finnish trades unions for both nursery staff and general municipal staff were initially opposed to the voucher experiment, concerned as they were about the likely effect of the scheme on existing employees’ terms and conditions. However, during the preparative stage, the unions actually began to offer advice to their members who were contemplating moving into private nurseries. In fact, the Finnish voucher experiment proceeded without any major conflict between trades unions, local authorities and central government. As such it stands in stark contract to the British experiment with vouchers, which were viewed by many to be an ideological imposition by a Conservative central government on unwilling local authorities (Burns et al. 1994). The practical arrangements for the trial of the voucher scheme were, to a large extent, left up to individual local authorities, with a rich variety of models emerging. These have been the subject of a large-scale review undertaken by the Ministry of Social Affairs and Health. The following section provides an outline of the findings from the interim report of this review, published in April 1996 (Heikkilä and Törmä 1996). The Voucher Scheme in Operation The evaluation that was undertaken by the Ministry of Social Affairs looked at all the cases where parents had used vouchers in the period up until the end of 1995, which equated to a total of 2,911 children. Each of the 33 local authorities involved in the trial was able to introduce its own model of voucher provision. With the monthly cost of municipal nursery care varying in 1993 between FM 2700 and FM 5300 authorities issued vouchers which covered anything between 50 and 100 per cent of the charges for private care. The precise value of the vouchers was dependent on the available resources of each local authority and a process of income-related means testing. Different authorities also took different views with respect to where vouchers could be used. The study found that in 20 of the 33 local authorities, parents could be viewed to have had a full and genuine choice of provision, in a number of cases this included being able to select childcare outside the authority’s own boundaries. Of the 2,911 children whose childcare was paid for through the voucher scheme, 45 per cent were already within the private day-care sector, a further 25 per cent, had previously been cared for at home and 17 per cent had transferred from municipal day care. So it seems that vouchers did cause some parents to

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transfer from one form of day care to another. Vouchers have thus worked as a partial incentive for parents to choose a preferred form of day care. This finding is supported by a survey that was conducted as part of the initial evaluation. The survey found that 23 per cent of parents used the voucher scheme to place their children in private nurseries simply because there were no places within the municipal sector. However, the survey also established that 22 per cent of parents used the vouchers in order to place their children in a nursery which had a particular pedagogical orientation, e.g. Rudolf Steiner schools. A further 13 per cent said they found private nurseries to be more responsive to their needs, a further 11 per cent cited practical considerations such as opening hours or closeness to their home, and a further 14 per cent were unable or unwilling to give a precise explanation for their decision. Introducing Choice, Improving Quality, or Cutting Costs? What then were the net results of the trial? Firstly, the central aim of the scheme had been to increase the overall supply of nursery places, using vouchers as a means of encouraging private providers to set up nurseries, so as to augment existing municipal provision. To this extent, the scheme could be described as modestly successful. New nurseries were set up, in most cases as small businesses run by two or three people. Larger companies, however, did not respond to any significant extent, citing high employment costs as having been a major deterrent. The voucher scheme did then change the overall structure of the private childcare market; the modest number of traditional private nurseries which were part of large private companies or which supported alternative pedagogical systems now stood alongside newer more commercially oriented small businesses. But it is harder to determine whether this increase in the overall supply of nursery places created an improvement in terms of efficiency, economy or quality. This is partly explained by the fact that the need for daycare services rose during the time of the experiment as a result of legislative change that significantly increased the demand for places. To get a full picture of the new system’s efficiency, its costs need to be analyzed from at least two different angles, those of the municipality and the parents. Of the two, municipalities have derived the most obvious economic benefits. The value of the nursery vouchers issued by local authorities was usually lower than the net cost of a nursery place. And this was the case in most of the participating municipalities, despite the variance in the face value of the vouchers. In other words, it is more economical to distribute vouchers than provide places in a municipal nursery. Standing against these potential savings have been the costs of setting up and managing the voucher scheme. Here the Finnish case study offers little if any evidence, as the scheme was in place for a relatively short space of time, so it generated few if any additional costs.

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Whether the voucher scheme represents a more efficient means for parents to gain access to childcare is less clear, particularly in the light of the significant cross-country variations. For those who were already using private nurseries without public support, vouchers offered some welcome financial relief. For a second group, vouchers did not really represent a realistic option, because they were unable to pay the difference between the vouchers and the cost of private childcare. Approximately one-fifth of parents in the scheme ended up paying bigger bills than before its introduction (Heikkilä and Törmä 1996). This then leads us to a consideration of the key issue of quality. Did the voucher scheme result in the provision of good quality nursery care, did it meet the needs of parents and did it result in greater choice? Answering such questions is made all the more difficult by the absence of a commonly agreed definition of quality. Some may see improvements as the provision of a flexible and heterogeneous service; whereas others may view any move away from a standardized and universal service as representing a decline. Examining the motivations of those parents who chose to take up an alternative day-care place, the interim evaluation of the voucher trial (Heikkilä and Törmä 1996) found the two most common reasons to be having “no other choice” and a preference for specialized day care. The first group consisted of families who were not able to find a municipal day-care place and who were thus compelled to accept a voucher; they cannot be considered as exercising choice. But the second group consisted of parents who had deliberately compared public and private, and who had chosen a private place for its service content. Nearly half of all parents who used nursery vouchers had their children in private nurseries before the start of the scheme. Yet taken as a whole, nearly half of all the parents who took up nursery vouchers cited their primary motivating factors as issues relating to quality and choice. This figure represents the 22 per cent of parents who chose private care in order to place their children in a nursery which had a particular pedagogical orientation, the 15 per cent of who stated explicitly that higher quality of private day care motivated their choice, and a further 13 per cent who emphasized the issue of responsiveness (defined as improved opportunities to influence the running of the nursery, better location, and greater flexibility in relation to opening times). Taken at face value, these findings would seem to suggest that private nurseries are more responsive to customers’ wishes than municipal nurseries. Such conclusions were supported by a second survey of parents which was conducted in two stages before and after vouchers were introduced (Heikkilä and Törmä 1996). A more complex picture, however, is revealed through a closer examination of the detailed findings. Firstly, both public and private day care were perceived to be of good quality and the differences between them were only viewed to be marginal. Secondly, the strengths of private day care lay in enhanced cooperation between the provider and the parents, and in the private nurseries’ ability to give children individual attention. The explanation for the perceived increase in influence with private nurseries may be the fact that many

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of the private nurseries were run by associations requiring the participation of parents. The strengths of public day care lay in the quality of the staff and general arrangements (food, rest, security). Nor do the findings mean that public nurseries did not encourage active participation in the production of their services. There is in fact a more or less constant dialogue between the staff and parents, necessitated in part because of the recession of the 1990s increasing the need for organized fundraising events. Seen as a whole, the findings do seem to suggest that although a significant percentage of parents who opted out of municipal provision did so for reasons of quality, a greater number did so because they valued alternative pedagogical systems or because they had no other choice than to go private. The findings also seem to suggest that a significant proportion of those who chose to remain with municipal provision also based their decision on choice and quality. The voucher scheme should be viewed primarily as a means to bring supply and demand into alignment, providing a broader range of service options. The trial affected only a fraction of the total number of children in day care and in many cases the municipal authorities proved willing and able to work alongside private producers. In the long run, however, there remains the risk that entrepreneurs taking a more hard-edged business approach may enter the market and create a more destabilizing environment for childcare provision. In summary, vouchers have given parents more choice, and the majority of users have found them to be an improved way of comparing and selecting a broader range of day-care options than had existed before. But lasting for only two years, the trial has been somewhat overtaken by events. A new childcare scheme was introduced in August 1997, drawing on the findings of the voucher trial. The new scheme has now formalized a system for financially supporting the private childcare market, while recognizing that the vast majority of childcare will continue within the municipal sector. The argument has now shifted to whether parents should be encouraged to stay at home with their young children —the most cost-effective option for the municipality—or whether the traditionally broad supply of public day care should be maintained so that both parents can work outside home. Conclusion Without doubt the landscape of the Finnish welfare state has changed significantly over the last decade. While this cannot be said to constitute a public policy revolution, there has been an evident shift towards a model of welfare pluralism. The rationale for this shift partly reflects a belief that greater choice will lead to greater voice, as municipal service providers are forced to listen more attentively to the needs of service users. However, encouraging private providers to enter the marketplace has also proved to be a cost-effective way of meeting increased levels of demand at short notice.

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The nursery voucher scheme trialled by the Finnish government thus provides an interesting case study in market-oriented welfare reform. Yet in drawing any conclusions, it needs to be remembered that vouchers were introduced as a twoyear trial at a time when long-term regional imbalances of supply and demand had been exacerbated by changes in Finnish law that significantly increased demand for day-care places. Nevertheless, the voucher programme has raised a number of important issues in relation to the principles and practice of marketoriented welfare reform. The first of these relates to the potentially contradictory directions these developments may take, especially the apparent conflict between the pressure for greater service differentiation and the principle of equality. The resolution of this dilemma is made all the more difficult by the willingness of some parents to spend more money in order to secure the form of day care they desire. The question remains as to what level of differentiation within the public service system can be allowed without damaging the loyalty of all citizens towards the core principles of the welfare state. It is easy to see how differentiation in relation to an individual’s access to services can, in the long run, lead to a reluctance to support the others who are not able to make the same choices. Thus, it is essential to let the preferences and not the resources of citizens dictate what choices are made available. Yet, as was apparent from this case study, a number of municipal authorities appeared to use the introduction of vouchers in order to transfer more of the financial burden for childcare onto the individual families themselves. In the long term one would expect the introduction of a market for childcare to lead to a closer match between supply and demand. However, until this happens, any consideration of the voucher scheme as a form of exit, in the sense that Hirschman intended, will by definition be flawed. Public nurseries may lose clients and may therefore seek to raise their standards in order to attract these parents back. However, it may also be that municipal authorities will use any change in levels of supply and demand as a smokescreen to reconfigure childcare towards lower cost options. And while some families do appear to have benefited from the introduction of vouchers, such benefits have largely been gained by families who already used private childcare or those who were able to use their vouchers in order to bargain for a better price from a service provider. Yet despite such problems, I still believe that a voucher system can paradoxically create an arena for voice, if related to the selection of a preferred form of public service, and in doing so aid the process that is local democracy. This argument can best be supported by making a distinction between two levels of participation. The first relates to the operation of each individual childcare institution. Here while one cannot a priori conclude that a private nursery will offer more or less access to voice mechanisms than a municipal nursery, the findings from the evaluative study in Finland have shown that a significant number of parents who decided upon a private nursery did so because they felt they had more chance of influencing its day-to-day operation. The

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second level of participation relates to where individual choices of day care are debated at the level of the municipal authority. This is the arena where the whole of municipal day-care policy can be debated: whether or not vouchers should be launched, what their value should be, where they should be used, and so on. In this sense, a regulated form of private choice can be used as a sign of consumer preferences, and consumer preferences may be considered as legitimate inputs to the policy process. Overall then, can the provision of vouchers be viewed as an innovation in public policy reform? Yes, to the extent it provides a relatively efficient and equitable way to increase both the level and choice of service options within a chosen field. But this will only occur where there is evidence of excess demand and where the vouchers themselves are not used to price individuals out of the market. However, it is less certain whether this in turn can be viewed as a degree of user empowerment. The provision of greater choice in the field of Finnish childcare appears not to have constituted an exit option, if exit is defined to be the voluntary transfer from one service to another with transfer out of services which are not satisfactory and where voice mechanisms have failed. Instead it was used to provide a greater number of entry options, although in the longer term, vouchers could be used to provide a more formal type of exit. Whether exit complements or undermines voice must remain one of the central issues of such a debate. References Anon (1994) Valfrihetsrevolutionen i Praktiken. Stockholm: Socialdepartementet. Baldersheim, H. and Ståhlberg, K. (1991) “Towards the self-regulating municipality” in Baldersheim, H. and Ståhlberg, K. (eds) Free Communes and Administrative Modernization in Scandanavia. Aldershot: Dartmouth. Burns, D., Hambleton, R., Hoggett, P. (1994) The Politics of Decentralisation: Revitalising Local Democracy. London: Macmillan. Heikkilä, M. and Törmä, S. (1996) Kokemuksia markkinaehtoisesta päivähoidosta. Väliraportti lasten päivähoidon valtakunnallisesta palvelurahakokeilusta. Sosiaalija terveysministeriön monisteita. Helsinki: Sosiaali-ja terveysministeriö. Henig, J. (1994) Rethinking School Choice: Limits of the Market Metaphor. Princeton NJ: Princeton University Press. Johnson, N. (1987) The Welfare State in Transition: The Theory and Practice of Welfare Pluralism. Brighton: Wheatsheaf Books. Kangas, O. (1994) The merging of welfare state models? Past and present trends in Finnish and Swedish social policy’, Journal of European Social Policy, 4, pp. 79– 94. Kettunen, P. (1998) Vaihtoehtoiset Kunnallisten Palvelujen Tuottamistavat. Helsinki: Suomen Kuntaliito. Klausen, K. and Ståhlberg, K. (eds) (1998). NPM og Norden. Odense: Odense Universitetsforlag.

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Milner, H. (1994) Social Democracy and Rational Choice: The Scandinavian Experience and Beyond. London: Routledge. Oulasvirta, L. (1995) ‘The impact of central government supervision on local government behaviour: the case of task-specific grants’, Finnish Local Government Studies, 22, pp. 333–9. Päivähoitopalvelut, L. (1995) Kilpailua ja Valinnanvapautta. Palvelujen Tutkimus-ja Kehittämishankkeen lasten Päivähoitopalvelujen Työryhmän Loppuraportti. Helsinki: VATT, Government Institute for Economic Research. Parsons, W. (1995) Public Policy: An Introduction to the Theory and Practice of Policy Analysis. Aldershot: Edward Elgar. Pollitt, C. (1995) ‘Management techniques for the public sector: pulpit and practice’, in Peters, G. and Savoie, D. (eds) Governance in a Changing Environment. Montreal: McGill-Queen’s University Press. Pollitt, C., Hanney, S. et al. (1997), Trajectories and Options: An International Perspective of the Implementation of Finnish Public Management Reforms. Helsinki: Ministry of Finance. Randall, V. (1995) “The irresponsible state? The politics of daycare provision in Britain”, British Journal of Political Science, 25, pp. 327–48. Rothstein, B. (1994) Vad bör Staten Göra? Om Välfärdstatens Moraliska och Politiska Villkor. Stockholm: SNS-förlag. Rothwell, S. and Pollitt, C. (1997) “The implementation of Finnish public management reforms 1987–1996”, Rothwell, S. and Pollitt, C. (eds) in Public Management Reforms: Five Country Studies. Helsinki: Ministry of Finance. Salminen, A. (1991) Organised Welfare: The Case of Finland’s Welfare Bureaucracy—A Nordic Comparison. Frankfurt: Peter Lang. Simonen, L. (1995) “From public responsibility to the welfare mix of care: private producers of social services”, Finnish Local Government Studies, 22, pp. 325–32. Walsh, K. (1995) Public Services and Market Mechanisms: Competition, Contracting and the New Public Management. London: Macmillan.

CHAPTER EIGHT Empowering the Parent: User Influence in the Danish Primary School System Eva Sørensen

Introduction During the last 25 years, the political system in Denmark has undergone a major transformation. One of the key elements in this process has been a radical decentralization of political and administrative power. The purpose of this decentralization has been twofold: to increase the efficiency of government by enhancing flexibility and hence focusing more on service outcomes, and to increase the level of influence and involvement of ordinary citizens in the governing process. These developments have found support from across the political spectrum in Denmark, albeit for differing reasons. The moderate forces, i.e. the Conservatives and the Social Democrats, have supported initiatives to make governance more efficient by means of administrative decentralization. In contrast, the New Left (Enhedslisten and Socialistisk Folkeparti) and the New Right (Venstre), which are both represented in parliament, have supported political decentralization in order to advance the empowerment of individual citizens in relation to public institutions. In order to understand this process of political decentralization in Denmark it is necessary to explore this apparently strange alliance between the New Left and the New Right. The mutual aim of both New Left and New Right has been to empower individual citizens in relation to public institutions; however, their respective strategies to achieve this aim have been radically different. The New Right has launched what could best be denoted as an exit strategy, focusing as it does on the enhancement of individual choice. By comparison, the New Left has promoted a voice strategy, aimed at increasing the opportunities for individuals to directly influence the nature and form of public services. The outcome of this process of political and administrative decentralization in Denmark must then be seen as a result of an ongoing confrontation between these two very different approaches. The outcome has been three separate waves of decentralization. The first wave saw the decentralization of a number of governing tasks from state to municipalities. This wave was initiated with the huge 1970 reform of municipal governance (Kommunalreformen) which, at one and the same time, increased the

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size of municipalities and gave them considerable political and financial autonomy within limits set by the state. The guiding principle of this reform was to create sustainable municipalities (Schou 1994). From 1970 up till the present day this process of decentralization has continued, with social policy and the primary school system being the two areas that have been most heavily decentralized. The second wave of decentralization was developed in the 1980s and involved the decentralization of government tasks and decision-making competence from municipalities to self-governing public institutions. As a result of this policy, a wide range of public institutions, including school nurseries, old people’s homes, primary schools and libraries, have become self-governing within financial and political limits set by the municipality. Each institution is now governed by a user board elected by all the users of the institution. The user board has the competence to decide the overall principles for the governing of the institution, while the actual governing is performed by an administrative leader. In that sense the system of governance within the institutions is a microcosm which reveals the distribution of competence between politicians and administration in state and municipal government. This second wave of decentralization has in turn coincided with increased freedom for service users to choose between services produced by different public institutions. Since the ability of institutions to attract users has become a central parameter for the size of municipal funding, this has led to a degree of competition within the sphere of public governance (Sørensen 1995). The third wave of decentralization, which began to develop towards the end of the 1980s has seen states and municipalities increasingly cooperating with private and voluntary organizations within civil society. This cooperation has resulted in the development of a “grey zone” of governance (Greve 1996) which is both public and private in the sense that both the purpose and the means of governance are mixed. Private firms are in it for profit, whereas states and municipalities seek to increase governance efficiency and obtain legitimacy; voluntary organizations focus on the ability to solve defined problems. Cooperation between voluntary organizations and public authorities is mostly found in the social sector, whereas cooperation between public authorities and private firms has been used to organize service performance such as transportation, cleaning and food production. The process of decentralization in Denmark has left behind it a multilayered governing structure. In what follows I have chosen to concentrate on the second wave of decentralization since, in a European context, the outcome seems to be somewhat unusual: strong channels of voice and exit have been institutionalized within public bodies. In concentrating on this second wave, remember that increased decentralization from state to municipalities (the first wave) needs to be seen as a precon dition for democratic empowerment in the shape of user influence in public institutions. That is to say, any attempt at political decentralization

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directly from the state to local institutions would institutionalize a distance between politicians and users that would be hard to bridge. This could be fatal since continuous and close dialogue between politicians and users is essential to enhance both democratic empowerment and the efficiency of governance. A degree of closeness enhances democratic empowerment because dialogue improves politicians’ level of knowledge about the viewpoints and concerns of citizens, and it also enhances governance efficiency because it enables better coordination of the policy process. Therefore, the value of user influence as a means of democratic empowerment depends on the presence of widespread municipal autonomy. However, while I consider the first and second waves of decentralization to be central ingredients in the institutionalization of increased user influence, I am somewhat puzzled about the possible consequences of the third wave of decentralization for local democratic empowerment. I sympathize with the basic idea behind this strategy of empowerment that civil society must play a more active part in the process of societal governance than has been the case in traditional institutions of liberal democracy. I can also find great value in the institutionalization of a space of publicly financed experimenting with alternative methods of solving publicly defined tasks. For example, it is impossible to exaggerate the value of publicly financed private schools and voluntary organizations doing social work for the refinement of methods of public governance in Denmark. However, private-public cooperation as institutionalized in the third wave of decentralization, appears to seriously limit the possibility of democratic control. Instead of moving government tasks from public institutions to civil society, a strategy of empowerment must introduce institutions of public governance which invite actors within civil society to take an active part in processes of governance within the public sector. The second wave of decentralization represents one way of doing this. The following sections take a closer look at how second-wave empowerment has been institutionalized in the primary school system in Denmark. User Influence in the Primary School System The primary school system in Denmark has been dominated by publicly governed schools. A mere 10 per cent of all pupils attend private schools, and even here approximately 70 per cent of expenses are publicly funded. This domination of the state sector has historical roots that go back as far as 1708, when the first public schools were established. From the outset, the Danish primary school system has been split into two. While the management of finances took place at the local level (the parish), substantive governance was performed by the church, and given its hierarchical character, this led to a highly centralized structure.1 Early organizational divi sion into financial and substantive governance between the local notables and the church lasted well into this century. It left very little room for

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selfgovernance in any individual school. From the beginning of this century, however, it is possible to identify a slow but steady change in the primary school system. This change has followed two lines. One has seen a slow process of decentralization of public school governance, which has been made possible by the gradual separation of the educational system from the church. This process received an initial boost in 1916 when the Ministry of Education was separated from the Ministry of the Church. Nevertheless, it took a few more years before the last remnants of direct church influence were removed. Not until 1933 did elected politicians obtain a majority of the seats in the School Directory, the main governing body for the schools. School commissions as governing bodies for schools in the local community were first set up in 1814. When first established they had no representatives from the schools—no school heads, teachers or parents. The first big step towards the integration of schools into the governing process was taken in 1904, when school heads and the teachers’ councils obtained the right to be heard in the School Commission. As early as 1933, parents were given the right to form a parents’ council at each school and to apply for representation on the School Commission. In Copenhagen the establishment of a school council with teachers, parents and the school head was made obligatory in 1949. The rest of the country followed in 1970. The rights of both parents and teachers to play an active role in school governance took a significant step forwards in 1990, when for the first time parents obtained a level of decision-making competence which gave them the formal right to have a significant input into the governing process. Firstly, the 1990 reforms further decentralized decision-making competence regarding substantive aspects of educational policy from state to municipalities and from municipalities to the individual school. This has meant that today in Denmark it is possible for an individual school to develop its own profile or identity within the limits of a broad policy framework. However, the main aspects of financial governance are still decided by the municipal council, just as the hiring and firing of staff remains a municipal task. The reforms also contained an element of centralization whereby the School Commission was abolished, with a consequential degradation in terms of user influence on municipal school governance. The decision-making competence for schools was divided between a user board with a majority of parents (in exchange for the relatively weak school councils) and the school leader. These school boards have been given the competence to decide on all matters of principle, leaving the school leader to govern with reference to these principles. In 1986 the general trend towards institutional autonomy and increased parental influence was supplemented by another important change carrying considerable implications for the structuring of the Danish school system. Traditionally, the ability of parents to choose between state schools was very limited. Every school had its district, and parents living within this district had to present very good reasons in order to be permitted to choose another state

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school. In general, if parents did not want their child to attend the state school for which he or she was eligible, then there was little option but to choose a private school. The 1986 revision to the School Governance Act introduced limited freedom of choice between schools, whereby parents were allowed to choose an alternative public school if there was room and once all the children within the immediate school district had been admitted. In conclusion the system of public school governance in Denmark today is characterized by provision for substantial parental and teacher influence at the level of the school; the price for this has been the removal of formal channels of parental influence on school governance at a municipal level. Thus, while formalized channels allow for considerable parental influence with regard to the governing of the individual schools, as well as a limited ability to choose between state schools, education policy at a municipal level is governed by local politicians and administrators. Parental Influence and Democratic Empowerment When analyzed from a theoretical perspective which relates to existing literature on public participation, two arguments can be put forward in favour of this change in the formal processes of public school governance. Firstly, the increasing integration of parents into the governing process which has resulted in a move from a marginal position within advisory bodies of governance to a dominant position in more powerful institutional bodies, can be seen to represent a step up Arnstein’s ladder of participation (Burns et al. 1994). Secondly, drawing upon the work of Hirschman (1970), the 1986 reforms with their focus on providing exit and the 1990 reforms with their focus on voice, could be described as constituting a movement from user participation to one of user control. Hirschman argues that the optimal balance between exit and voice options would involve limited access to exit and easy access to voice. The limited exit option makes it possible to leave if the outcome of collective rule is unacceptable, while the easy access to voice channels of influence serves to direct resources among the users in the direction of improving the quality of the outcome.2 This balance between exit and voice is exactly what has been institutionalized with school boards, granting users considerable voice influence on the governing of the individual school and exit influence through a limited freedom of choice between schools. The above discussion gives the reader every reason to believe that the reform of state school governance in Denmark has resulted in the greater empowerment of parents with respect to the governing process at individual schools. So it is all the more surprising that research case studies of state school governance in the 1990s reveal that parents, contrary to the declared aims of the reform programme, and contrary to what could be expected from an evaluation based on the work of Hirschman or Arnstein, play no more than a marginal role in the governing process in schools (Cranil 1994; Sørensen 1995; Kristensen 1997). In order to

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explain this divergence between the expected ability of the formal structure to increase the level of parental empowerment and the actual distribution of influence in the governing process, we need to recognize the incomplete explanatory power of theories of empowerment proposed by Arnstein and Hirschman. In doing so, we need to address theories of empowerment which recognize the influence of culture, or more precisely, the influence of the specific universe of meaning and related roles which constitute an institution (March and Olsen 1989). This is the aim of the chapter. Roles and Universes of Meaning In recent years the notion that an institution is constituted by a specific universe of meaning rather than by formal rules has become dominant within the social sciences (Knudsen 1989; Dimaggio and Powell 1991; March 1995). March and Olsen (1989) term this universe of meaning a “logic of appropriateness” in that it defines what is considered to be suitable, normal and acceptable behaviour. By structuring actors’ perceptions of themselves and others, this logic gives direction to their actions within a given institution, although it cannot be said to determine their behaviour. When individuals are part of a structure of meaning, they have to internalize that structure and the meaning which it ascribes to their role. In this process the role is transformed into an identity that the individual is able to live with. Thus seen, it is obvious that institutional change is a difficult process, for individuals do not abandon overnight their internalized roles—let us call them institutionalized identities—and attempts at change are rarely achieved without pain or problem. It is crucially important to recognize the internalized nature of these roles when reflecting on why efforts have failed to increase parental influence in the Danish primary school system. Evaluating Teacher and Parent Reactions The research findings from the case studies of school governance in Denmark reveal that many parents refrain from using the channels of influence they have gained access to, and a majority of teachers appear determined to prevent parents from gaining any such influence. These studies show that many parents are highly sceptical about the potential for parental influence on issues concerning the core activity of the school, the teaching, primarily because parents do not feel they have the knowledge needed to take part in the decision-making process. For that reason many school boards spend most of their time discussing what may be termed marginal issues, such as those concerning the physical environment or social activities (Sørensen 1995). Furthermore, only a minority of the parents who are not on the school board show interest in the work it does, something reflected in the low participation rates for school board elections (Larsen 1992; Cranil 1994; Sørensen 1995). This situation stands in stark contrast to the considerable interest which parents show when it comes to issues concerning

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their own children. For example, research has established that a majority of parents attend parents’ meetings in order to discuss the progress of their own child. With regard to the position of teaching staff, research established that a large number of teachers have taken deliberate action in order to prevent an increase in parental influence. Firstly, teachers used a collective, organizational exclusion strategy when the 1990 act was negotiated. The Danish Union of Teachers did all it could to influence the legal division of competence between parents and teachers, ensuring that the teachers maintained the freedom to choose teaching methods and that the headteacher of each school would become the secretary for each of the school boards. Secondly, teachers have used what may be termed individualistic exclusion strategies; they have formed powerful informal networks within each school which enable them to circumvent the school boards (Sørensen 1995). This has been done by establishing a close link between the teaching staff and the headteacher. For parents that are members of school boards, such an alliance has proved hard to break down. However, in cases where parents do appear to be gaining the upper hand, teachers have adopted a second strategy; they use professional and technical terminology in order to confuse, bemuse and outwit the parents. For instance, teachers may turn what is a normative debate into a discussion of technique, thereby limiting the ability of parents to participate fully in the discussion. However, teachers have also been known to form alliances with sections of the parent body. This alliance making between teachers and parents is often found in situations where the challenge to the teachers’ hegemony comes from outside the school, be it from the municipal authorities or other schools (Larsen 1992; Cranil 1994; Sehested 1995; Sørensen 1995). The importance of these alliances in maintaining the primacy of the teaching staff is reflected in the finding that school boards rarely vote in order to reach a decision (Larsen 1992; Cranil 1994; Sørensen 1995). If these reactions are considered as action taken in a situation where a specific universe of meaning and a specific role structure is being confronted by an attempt to change the policy environment, then the reactions of both parents and teachers can be seen as quite natural. Hence both groups have done nothing more than stick to their traditional roles as prescribed by the traditional universe of meaning within the Danish primary school system. In order to develop this argument further, we need to take a closer look at the traditional universe of meaning and the related role structure in the Danish primary school system. The Primary School System: Part of a Welfare State Universe of Meaning The primary school system is a key institution within the Danish welfare state. The Danish welfare state is itself best characterized as “an autonomous state” in that it plays a major part in the development and protection of the basic social

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and cultural norms and values of Danish society (Jørgensen 1993). This task is carried out by the professionals employed in the public sector, who are not only regarded by the public as being technically superior within a specific field of governance, but are also regarded as being in the best position to define the common good. There are two reasons why professionals in the Danish welfare state enjoy such a position. Firstly, Burrage and Torstendahl (1990) argue that the link between rationality, reason and education provides a solid basis for professional legitimacy. For who are the obvious media of a rational common sense if not the educated? Secondly, the dominant position of professionals within the Danish welfare state reflects the very close link between professionals and the state education system. The monopoly that exists here is meant to guarantee the production of the desired number of professionals, the desired level of technical qualification and the socialization of the professional class that is necessary to prepare them for the universe of meaning which prevails within the welfare state (Olsen 1986; Sehested 1996). Thus, normative and technical aspects of public governance meld together. What then can be said in relation to the vote of users of the welfare state in Denmark? Each Dane has two roles to play in relation to the welfare state: being a citizen, that is taking part in the governing process by voting in elections; and being a client, the recipient of state goods and services. Within this traditional universe of meaning, the role of the client or user is often characterized as being passive or irresponsible, incapable of making a constructive contribution to the policy process. Due to a sharp institutional separation between the image of the active, resourceful citizen and the image of the demanding, incapable user, we are left with a perception of the relationship between professionals and users being highly asymmetric. The professions are as strong as the users are weak. This asymmetry is very much present in the traditional relationship between teachers and parents within the primary school system. The Traditional Role of Teachers The traditional teacher is a true welfare state professional. Two characteristics are central to this view: authority of knowledge and autonomy (Sehested 1996). The authorized knowledge of the teachers is based upon scientific knowledge about one or more specialized fields and the ability to teach (pedagogics). Their professional identity is primarily founded upon this technically oriented authority of knowledge. However, teachers also possess another cul turally determined authority of knowledge, and it can be revealed by examining the history of the teaching profession. During its early years, when the primary school system was governed by the Church, teachers were regarded as wage earners, while the vicar was the primary carrier of God’s delegated spiritual authority. The vicar hired teaching staff and controlled the level of the pupils’ attainment (Markussen 1971). From the turn of the century onwards, the school system was moved from the Ministry of the Church to the Ministry of Education. In this process the

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spiritual foundation of professionalism disappeared, and the teachers became the carriers of a new form of authority that was not based on a link to the Divine but on the ability of rational reasoning achieved through education. As a consequence, teachers developed a very strong professional identity, reflecting both the homogeneity of the system that educates teachers and the existence of a strong teachers’ union, the Danish Union of Teachers. Teachers have enjoyed a high level of autonomy from other teachers, administrators, users or politicians. This autonomy relates both to working conditions and professional demarcation. In relation to working conditions, teachers have been able to decide their own teaching methods, in the sense they have been given the freedom to interpret the very general principles of teaching as described within government legislation. With regard to professional demarcation, only suitably qualified teachers are allowed to teach in the public schools, which represent 80 per cent of the schools in Denmark and cover 90 per cent of all pupils. This position is further enhanced because a large number of administrative leaders in school management are trained teachers, at both state level and municipal level. Within the teaching profession itself, it is also possible to identity a specific decision-making culture which helps to reinforce their ascendant position within the educational policy field. This culture is one of collective governance based around the discussion of like-minded professionals. Over the years, this decision-making culture among teachers has developed into a form of collective governance based on the principles of direct democracy (Sehested 1996). The Traditional Role of Parents The traditional role of parents within the governing of the primary school system stands in line with the description of the service user in the welfare state, outlined in the previous section. There is in fact a striking contradiction between the role of the parent and the formal rules of school governance. While parents have enjoyed formal representation on municipal school committees since 1939 and on advisory school councils since 1970, this tradition of formal parental influence does not in any way reflect the actual influence that parents have exercised (Helle-Nielsen 1986). As has been alluded to earlier, parents have in fact only had any real influence on marginal issues, such as social events, and on efforts to increase a school’s budget. They have had little direct influence on the key objective of the school, namely teaching. Added to this is the fact that only a minority of parents have participated in the policy process (Hoff 1993; Sørensen 1995). The majority of parents have only become involved in parents’ meeting, where parents are more of an audience listening to teachers summarizing the events of the past year and presenting future plans, than active participants. The discrepancy between formal rules and the actual level of parental influence is the result of a number of specific institutional conditions regarding

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the relationship between teachers and parents. Firstly, the relationship is between experts and laypersons, where both technical and practical knowledge about teaching is divided unequally between teachers and parents. Secondly, teachers evaluate the performance of pupils, playing a central role in determining their futures. Consequently, teachers offer pupils a means to achieve success, while at the same time holding the potential to undermine or upset that very same chance of success. Thirdly, it must be remembered that parents are not in fact the real users of the education service; the real users are the pupils. Therefore, parents do not have first-hand knowledge about the conditions of daily life at any given school, which makes it difficult for them to confront teachers in any case where conflict has arisen. These basic conditions point to a functional asymmetry between parents and teachers. However, the lack of parental influence in the primary school system is first and foremost a result of the welfare universe of meaning, according to which the functional asymmetry has been handled. This raises two fundamental points. Firstly, the functional asymmetry in the sphere of education is strengthened because we culturally attach great importance to expert knowledge. Secondly, there is a clear divergence between teachers and parents regarding the tradition of organizing themselves. The tradition is strong among teachers but is almost non-existent among parents. Seen as a whole, the universe of meaning in the primary school system and the relationship between teachers and parents which it dictates, coincides with the universe of meaning characterizing the Danish welfare state as a whole. Given such a background, the negative reactions of many teachers and parents to the implementation of increased parental influence in the governing process, might appear more understandable. Tradition and Empowerment Efforts to increase the influence of parents over the governing of primary schools have proved to be a serious thorn in the side of teachers. Or to put it more pointedly, the greater involvement of parents in the policy process has proved to be incompatible with the traditional professional identity of the teaching profession. If decisions of principle were to be made by parents, this might potentially conflict with the teachers’ own educational and ethical authority of knowledge, which is concerned as much with ideas of principle as with matters of detail. It would therefore be incomprehensible to teachers that laypersons would be able to make decisions regarding these matters, while they as experts were marginalized. Yet it remains likely that the newly gained competence of parents regarding the formulation of basic principles for the governing of schools, makes it both possible and likely that they will at some point seek to control the process of policy implementation. Not only would this challenge the individualistic and privatistic working method of the teachers, it would also undermine teachers’

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ability to define educational goals. While the reforms do not extend parental influence to detailed matters concerning the organization of the teaching process itself, school boards will infringe upon a greater range of issues relating both to broader policy and more day-to-day issues. And while teachers are used to participating in collective decision-making processes concerning the governing of the school, the central problem relates to making room for parents in this process. This is likely to prove problematic not only because teachers have had little or no experience of cooperating with people who are not teachers, but also because this must be attempted alongside the introduction of a hierarchical management structure within the teaching profession itself.3 There are several reasons, then, why one would expect teachers to react in a negative manner to any attempt to increase parental influence. But what about the parents? How does the increased access to influence fit the traditionally marginal role played by parents in the governing of primary schools? The new system of governance in Danish schools is based on the notion of parents as active, competent and responsible actors in the governing process. Yet the traditional role is based around a view of parents as passive and grateful recipients of an educational service. This leads me to conclude that efforts to increase parental influence in the governing of primary schools in Denmark have not only come up against the traditional role of the teachers, but have also proved to be incompatible with the traditional role played by parents. This in turn raises the question as to whether or not institutional change is possible in situations in which an existing universe of meaning appears to be incompatible with the intended change in policy direction. Is Change Possible? Is change possible? To help answer this question, one may consider the work of March and Olsen (1994) regarding changes to the established logic of appropriateness. March and Olsen claim that logics of appropriateness are far from autonomous or completely closed, and they cannot be said to determine the behavioural pattern of the members of an institution. To survive in times of change, these systems of logic must leave considerable space for interpretation and adjustment. Hence one can speak of an inherent incompleteness, a breach, in the universe of meaning represented by any institutional logic of appropriateness. For this reason, efforts to change institutions must aim at identifying and expanding such breaches. How is this done? Breaches in a universe of meaning are found in situations where specific actors face difficulties in maintaining their pre-existing position; for instance, it is difficult to maintain a position when it becomes a barrier to the efficient realization of desired policy goals. Then the likelihood of a change will partly depend on the awareness of this breach among the actors. But to bring about change requires more than just awareness. Awareness does not help to direct the process of change; direction is

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more likely to come from alternatives to the traditional universe of meaning and alternatives to the traditional roles played by each group of actors. Linking the work of March and Olsen back to the public primary school system in Denmark would lead one to focus on breaches within the traditional roles of teachers and parents, alongside the formulation of potential alternatives to these roles. Within this context, particular attention should be paid to the role of teachers. Given the functionally asymmetric relationship between teachers and parents mentioned earlier, changes in their attitude with respect to parental influence is likely to be the very key to the institutionalization of parental influence. This is the subject of the next section. Breaches in and Alternatives to the Traditional Teacher Role It is in fact possible to locate a few radical breaches in the role of the teacher with regard to the character of their knowledge, their working methods, their autonomy and their decision-making culture. If we look at the character of their knowledge and their working methods, it is possible to identify changes in their relations with pupils, parents, other teachers and other professional groups. As a result of the anti-authoritarian educational movement of the 1960s, teachers have paved the way for a more proactive and independent pupil role. This development can and should be seen as constituting a first breach in the teachers’ armour against lay influence. Secondly, when examining the role played by parents, a similar change in attitude seems to have spread among teachers, based at least in part on the realization that professional goals are often best obtained where there is a high level of cooperation between home and school. In fact, many teachers have found it impossible to introduce new teaching methods without the cooperation of parents, and parents have to feel safe about the new methods if they are going to support the policy within their homes (Sørensen 1995). So if only for professional reasons, teachers have come to recognize the need to establish a cooperative relationship with parents regarding every individual child and every individual class. This development has been aided by the breakdown of the traditional division of labour between teachers and parents with regard to both teaching and the upbringing of the child. Today teachers play an increasing role in the upbringing of children, just as the success of pupils depends more and more on the degree to which parents support the efforts of the teachers in the classroom. Important changes are also taking place with respect to the relationship between teachers, and between teachers and other professional groups. Teach ers are increasingly moving away from privatistic working methods through the greater use of teaching teams. The relationship between teachers and other groups of professionals is changing, mainly due to recognition by all parties of the need for interdisciplinary cooperation to improve the ability of the public sector to produce educated and well-functioning citizens. In this process the

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professional identity of the teachers is influenced by a general development among public sector professionals, whereby a common point of reference develops for teachers, administrators, social workers, psychologists and other related professionals, which makes cooperation and negotiation possible. If we focus on the teachers themselves then further potential breaches in their institutional logic of appropriateness can be identified. Teachers are of course citizens and users in other spheres of their lives. They, like all of us, will have been influenced by the general cultural and ideological change towards treating users as active, capable and legitimate contributors to the policy process. This perceptual change might explain the presence of a strong ambivalence in teachers’ attitudes to increasing parental influence. On the one hand they support the principle of giving parents more influence, while on the other they remain sceptical about defining issues of how much and over what areas. The autonomy of teachers has been further undermined by a loss of managerial influence at both state level and municipal level. Fewer teachers are employed in the Ministry of Education, while teachers in the municipalities have lost their formal right to have a teacher as their administrative executive. A number of municipalities have even gone as far as to decide that education should no longer have its own administrative department or political committee. Schools have also been subject to new management instruments such as political goal setting, service declarations, management plans and performance measurement. These instruments suggest a stronger weighting towards the political, administrative and lay control of schools. Finally, in relation to the decision-making culture of teachers themselves, we have mentioned that headteachers have tended to uphold their chosen role as professional teacher by making alliances with their fellow teachers rather than with local parents. Yet headteachers are now beginning to realize that increasing competition between schools for pupils will make establishing good relationships between themselves and parents a higher priority than in the past (Sørensen 1995). It is therefore possible to identify radical changes within the traditional role of the teacher. These changes have broken down the barriers between teachers and other actors, exchanging the principle of labour distribution for the principle of cooperation. In this light, the efforts of the 1990 act to increase parental influence are best seen as no more than another step in an ongoing movement away from the traditional teacher role. Yet if this is the case, why have teachers sought so vigorously to resist the implementation of greater parental influence? Although there are several reasons, the lack of any other attractive professional identity is likely to be one of the most important. If teachers do not have an alternative professional identity, they are likely to be forced to defend the one they have. Accordingly, a real breakthrough in establishing a democratic culture of cooperation between parents and teachers would involve a thorough debate on how to develop a new and more responsive professionalism for teachers. This, one may propose, would involve a professional identity built on the principle of

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cooperation with others, because it recognizes the value of their knowledge as fellow professionals or laypersons. The starting point in this search must be a thorough reconsideration of the nature of professionalism. This would question whether the professional represents the superior incarnation of all relevant knowledge regarding a defined issue, or whether he or she is merely a person who has spent more time than most studying a specific issue. If a professional is a superior incarnation, and parental influence serves no purpose except to satisfy the wish of parents to be heard, then consultative bodies which possess merely an advisory function would appear to make sense. But if professionalism is about length of study, and parents are viewed as an important source of relevant knowledge, then a more developed role in the policy process would be justified. Yet to some extent it is irrelevant whether teachers are willing or able to accept this new definition of their role; circumstances will increasingly force their hand. What they should bear in mind is that losing an authority based on the exclusive possession of all relevant knowledge does not in itself necessarily signify an end to all authority. What it is likely to mean is that the authority of the teacher will rest upon the judgement of others as to the ability of the professional to get the job done an authority based upon democratic principles. Formal Reform and Institutional Change Where then does all this leave the reformers? Will they just have to sit back and wait to see what happens, in the hope that teachers and parents eventually create a new universe of meaning with structures that empower parents? Or can there be a more proactive role? The answers are no, the wait-and-see model is not the only one; and yes, proactive reform is possible. However, reformers must recognize that an empowerment strategy will need to link a short-term approach to a more long-term approach. In the short term, changes in the formal policy process must aim to increase potential and existing breaches in the universe of meaning, thereby making alternative roles attractive to teachers. For example, parental influence might be promoted by structuring it into the place where both parents and teachers have shown some willingness to cooperate, i.e. at the level of the individual class and the individual child. Secondly, teachers might be less resistant to parental influence if they were given a greater influence over other governing structures such as the school board. An increase in teacher representation from the current two out of nine might allay the widespread fear among teachers that, in the long term, parents could seek further reductions of their influence. And feeling less fearful, teachers might open their eyes to the potential advantages of bringing parents into the system of primary school governance. To accomplish radical institutional change, I believe in using formal changes in the structure of governance as a means to promote broad-based changes in the traditional universes of meaning and the traditional role structures. In the long

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term, formalized control in these governance structures should be established as part of an extensive provision for voice and a more limited power of exit, with the aim of establishing a universe of meaning compatible with this revised power structure. Notes 1. Denmark has had a “state church” ever since the reformation in 1536, when the Church was placed under the jurisdiction of king. This has produced a highly centralized church structure with little room for competition between different churches. Accordingly, differences in viewpoint on pedagogical issues, as with religious differences, were mostly settled within the hierarchical system of the state church. 2. Hirschman’s concepts “exit” and “voice” are developed for a slightly different purpose. His aim is to develop a theory of how individual behaviour ought to be institutionalized in order to increase outcome efficiency (Hirschman, 1970: Ch. 1). In the present context the aim is not institutional outcome efficiency but the enhancement of individual empowerment. Hence exit and voice represent radically different means of empowerment for individuals in relation to institutions. This transplantation of the concepts from one perspective to another is justified in my 1997 article “Democracy and empowerment”,Journal of Public Administration, 74, 3, pp. 553–67. 3. The 1990 act which introduced a greater say for school boards also concentrated all managerial power in the hands of the headmaster.

References Burns, D., Hambleton, R. et al. (1994) The Politics of Decentralization: Revitalising Local Democracy. London: Macmillan. Burrage, M. and Torstendahl, R. (eds) (1990) Professions in Theory and History. London: Sage. Cranil, M. (1994) Decentralisering og Selvforvaltning i Folkeskolen. Copenhagen: Ministry of Education, Primary School Department. Dimaggio, P. and Powell, W. (1991) “Introduction”, in Dimaggio, P. and Powell, W. (eds) The New Institutionalism in Organizational Analysis. Chicago IL: Chicago University Press. Greve, C. (1996) Gør den gå Zone Farverig. Copenhagen: Jurist-og Økonomforbundets Forlag. Helle-Nielsen, I. (1986) Skolevæsenets Sammensætning og Indflydelse. Copenhagen: Arbejderbevægelsens skolekontaktudvalg. Hirschman, A. (1970) Exit, Voice and Loyalty. Cambrige MA: Harvard University Press. Hoff, J. (1993) “Medborgerskab, brugerroller og magt”, in Andersen, J. (ed.) Medborgerskab—Demokrati og Politisk Deltagelse. Copenhagen: Systime. Jørgensen, T. (1993) “Modes of government and administrative change”, in Kooiman, J. (ed.) Modern Governance. London: Sage.

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Knudsen, C. (1989) Ny-institutionalismen i Samfundsvidenskaberne. Copenhagen: Forlaget Samfundslitteratur. Kristensen, N. (1997) Støvets Fortællinger. Aalborg: Aalborg University. Larsen, M. (1992) Har Skolebestyrelserne fået styr på Skolen? Roskilde: Roskilde University. March, J. and Olsen, J. (1989) Rediscovering Institutions. New York: Free Press. March, J. and Olsen, J. (1994) “Institutional perspectives on governance”, unpublished paper, Stanford University. March, J. (1995) Democratic Governance. New York: Free Press. Markussen, I. (1971) Folkeskolens Tilsyn Gennem 150 år—En Orientering. Copenhagen: Institute of Educational Research. Olsen, J. (1986) “Foran en ny offentlig revolusjon”, Nyt Nordisk Tidsskrift, 3, pp. 26– 35. Schou, B. (1994) “Det kommunale sevstyre: fra bæredygtighed til nærhedsprincip”, in Ibsen, M., Nielsen, P. and Schou, B. (eds) Folkestyre og Forvaltning. Copenhagen: Jurist-og Økonomforbundets Forlag. Sehested, K. (1996) Professioner og Offentlige Strukturændringer. Copenhagen: AKF Publications. Sørensen, E. (1995) Democracy and Regulation in Institutions of Public Governance. Copenhagen: University of Copenhagen.

CHAPTER NINE Some Concluding Thoughts Usman Khan

Introduction In Chapter 1 I discussed how over the last two decades the public policy agenda across northern Europe has witnessed a significant coming together. As the financial imperatives of the post-oil-crisis era impacted upon Western economies, so governments increasingly came to accept the need for a common set of public management remedies. However, set alongside this has been a recognition that for a changed management agenda to be successful within the public sector, it must also seek to address apparent structural weaknesses within local democracy itself. The result has been simultaneous pressure to introduce more efficient forms of managerial problem solving and to produce policy outcomes which are built upon a broad degree of democratic legitimacy. These two factors have acted together within the public policy arena to produce complementary forms of participation (CFPs), as defined in Chapter 1. The central purpose of this book has been to provide a critical account of some of these recent innovations, attempting to explain how they are affected by the apparently contradictory trends outlined above. This concluding chapter seeks to take the discussion forward, firstly by re-evaluating each of the innovations, using the public involvement matrix to establish the aims, audience, and target point in the policy process. In doing so, it will help to establish how far each CFP has been focused on instrumental rationality rather than communicative rationality. This will lead me to examine the relationship between voice and exit, before I draw together some common themes and provide a commentary on current trends in local governance. The Public Involvement Matrix The first stage is to agree a means of classifying and evaluating the mechanisms, so as to help one decide what works best, where and why; this is far from straightforward. The evaluative models put forward by writers such as Arnstein (1971) and Burns et al. (1994) offer one way to categorize the initiatives considered in this book. However, their normative underpinning lends

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Figure 9.1 The public involvement matrix: revised version.

them only limited flexibility to evaluate an initiative using its own terms of reference, and they do not allow easy evaluation over time or with respect to different sets of circumstances. So the public involvement matrix, as outlined in Chapter 2, has been proposed as a complementary vehicle to aid this process. It does this by focusing on both inputs and outputs. What I have attempted here is to present the public involvement matrix so that it is able to consider the dynamic potential of each initiative (Figure 9.1). For instance, with the choice questionnaire, one can view the line moving between the holistic and the particularistic as representing both the potential and the limitations of the process which Danielle Bütschi has termed “selfreflection”. Viewed in this manner, the public involvement matrix highlights how in all but one case in this book, participative mechanisms have demonstrated different degrees of lateral movement, in that they will operate in, or will have the potential to operate in, a more particularistic or more holistic manner. For instance, taking the Drogenstammtisch, it was apparent from Daniel Kübler’s account that he felt it to be a holistic and collectivist mechanism. However, where it was used to promote the particular interests of the community of Kleinbasel, the divide between the holistic and particularistic becomes more blurred. Yet this in itself should not be any real surprise.

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The decision-making process can best be viewed as a continuum that runs from inception to implementation. At the start of the process, the breadth of the agenda will be at its widest and this represents the maximum degree to which a holistic approach can be adopted. As one moves closer to the point of implementation, the debate becomes more particularistic. For example, a discussion on the subject of rationing public health services will be more likely to make individuals think beyond their own immediate circumstances than a discussion on the layout of a new hospital ward. This should not be a problem, unless the consultation process is focused solely on issues of implementation, or where broader policy issues are addressed in a way that militates against the generation of holistic outcomes. Vertical movement represents the ability of mechanisms to address the community as a group or as individuals; compared with horizontal movement, it seems far more rigid. The only exceptions are the health panels, school boards and in a particular way, nursery vouchers. In the case of health panels, the flexibility refers to the fact that several have used a range of different consultative techniques, from focus groups to postal questionnaires. This means they cannot be treated as a CFP in the same manner as say planning cells. School boards offer a more tangible form of vertical movement; although they are primarily focused on relating to parents as a collective, teachers in particular have also used them as a base from which to relate to parents as individuals. Nursery vouchers at first glance offer an example with no potential for horizontal or vertical movement. The static nature of this mechanism and its placement in the individualistic and particularistic quadrant, reflects the fact that it was focused wholly on the individual who uses their voucher in order to meet their own immediate instrumental needs, with no direct consideration of what may or may not benefit the wider community. However, the dotted line represents the view that the voucher scheme was intended to improve the quality of childcare services as a whole, albeit by parents acting through selfinterest within the marketplace. The Public Involvement Matrix: A Normative Model?

A particular point raised in Chapter 2 is the extent to which the public involvement matrix can be considered as a normative model. If one takes the arguments of writers such as Offe and Preuss (1991) and Jürgen Habermas (Outhwaite 1994) then a normative reading of the public involvement matrix would be relatively straightforward. Given the commitment of these writers to the collective and the deliberative, the top left-hand corner of the matrix would represent the best form of public involvement and the bottom right-hand corner would represent the weakest form. However, there was a deliberate intention in putting the matrix together to present an alternative or at least a complementary system for the classification of participative mechanisms, which avoided the normative underpinning of

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traditional systems. This was based on the premise that while traditional evaluative systems equated good public involvement with an extension of the democratic process, a large number of mechanisms that are developed by state agencies take a more instrumental view of the policy process, viewing public involvement as a means to enable a better policy outcome. Although the concept of “better” does beg the question of in whose view an outcome is better, it also suggests that a better outcome may not necessarily equate to a more democratic outcome. Such an argument would lead one to conclude that empowerment in its broadest sense should be concerned with using a range of mechanisms which provide options both for voice and exit; the top left-hand corner of the public involvement matrix represents the strongest form of voice mechanism and the bottom right-hand corner represents the strength offered by the exit strategy. The public involvement matrix can provide an interpretative framework for considering the functional and normative aspects of each participative mechanism. Evaluating the Mechanisms Participative mechanisms can be evaluated in a number of distinct ways. This relates to the fact that not only are mechanisms targeted at different audiences but they can also be said to act in different ways. In order to take this forward, I will investigate the mechanisms discussed in this book in terms of the why, the who and the when. The why relates to the aims of the mechanism, establishing what they were in the eyes of those who set them up and, to an extent, those who then became involved in them. The who relates to the individuals, groups or communities which were the target audience for the mechanism; it seeks to establish how the targeting of different groups relates to the original aims of the initiative. The third angle, the when, looks at the points in the policy-making process upon which each mechanisms is focused. A Vision of Consensus Establishing the aims of participative mechanisms that are focused on voice may appear at one level to be a simple task, in that they are concerned with broadening the range and number of people who are involved in any particular policy process. They may do this by building upon the representative democratic system or by forming part of what may be termed the managerial policy process. In each case the structure of any empowering mechanism will in turn govern the extent to which it will be directed towards instrumental problem solving as opposed to seeking democratic legitimacy. This in turn will impact on whether a particular mechanism is seeking to establish compromise as opposed to consensus, and the degree to which such an outcome is based on a process of deliberation. A majority of the mechanisms discussed in this book are focused on implementational aspects of the policy process. Consider the health panels in

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Chapter 6; Maggie Mort and her co-authors argued that the panels represented a contested field of interpretative flexibility, where it proved very difficult to establish the aims of the programme as a whole or of individual initiatives within it. Thus, at one level, health panels could be seen to constitute an attempt to bolster the democratic framework within the British health service, where, in the absence of elected politicians, centrally nominated boards of health authorities and trusts have sought to develop means to achieve democratic legitimacy. However, Mort and her co-authors go on to argue that rather than forming part of a consultation movement, the development of panels has been more characteristic of a “consultation industry”, where at best the aim has been to provide a further input into a pre-existing policy process, and at worst it has been to provide a source of legitimacy for a predetermined managerial agenda. In comparison, the German planning cells appear to offer an example of a system of public involvement which is at least ostensibly politically driven. For a series of planning cells to be set up, an official commissioning body must come forward. However, like the citizens’ juries which have been introduced in recent years into Britain and the United States, the planning cell process remains solely advisory. Examining whether a particular mechanism follows a managerial or democratic agenda is likely to be far from straightforward. Not only do both types of mechanism deal in the same rhetoric, but to an extent the divide may be a false one, in that both seek to extend the parameters of the decision-making process. Yet the difference is an important one, and it can be related back to the Habermasian divide between instrumental and communicative rationality (Outhwaite 1994), with communicative rationality representing the deliberative and democratic outcome of a process of discourse within the confines of civil society, as opposed to an instrumental outcome focused on the immediate needs of the state. Yet on another level the value of a particular participation initiative can also be related to the scope or breadth of issues it has been established to address. One can contend that if a consultative mechanism is employed to involve people in what may be considered a minor issue, such as the opening hours of a new medical centre, then that mechanism may well be highly democratic. It may involve all the relevant groups and individuals who may be seen to be part of the policy community, and may employ the most enabling of democratic systems which allow for full debate and discussion. Such a mechanism may also have an almost open agenda, in that the health authority may not yet have decided what opening times it would like. However, it cannot be viewed as empowering in any significant sense, because it is concerned with something peripheral to the central questions and issues relating to the provision of health care. This in turn should temper any consideration of the extent to which any of the mechanisms considered in this book have used deliberative decision-making systems. It is striking that within recent developments in public involvement there has been a move away from mechanisms which seek to reflect the immediate or unconsidered views of the public, to those which attempt to engender

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deliberative views and which are based on considering a broad range of information over a period of time. This has been most striking in the example of the planning cells in Germany and the citizens’ juries in Britain; they have involved a degree of involvement in the policy process for ordinary members of the public which would not have been considered possible or maybe even desirable ten or twenty years ago. So too with the choice questionnaire, we have an example of a technique which had become strongly associated with the production of individualistic and particularist views, being modified to encourage a more self-reflective approach. Even in the case of the Drogenstammtisch, which in structure has followed more traditional lines, there was an apparent commitment to ensuring that all the groups represented were able to contribute fully to the discussions that took place. However, while there has been a significant move towards more discursive forms of public involvement, this has not been linked to such mechanisms being given any meaningful control over the policy process itself. In fact, if anything, a tentative link can be made between the degree of deliberation built into a particular mechanism and the absence of tangible formal power being devolved to that mechanism. Thus in the case of the planning cells and citizens’ juries, their power has never been more than advisory and they have had to rely on the legitimacy generated by the jury process rather than any formal power in order to see their findings acted upon. In the case of the Drogenstammtisch, a lack of statutory power did not stop it establishing itself as the single most important policy-making body with respect to drugs policy in the Kleinbasel area. Maintaining a distance between the state and the CFP can be problematic, in that mechanisms are often more difficult to finance and views may be more easily ignored. However, as shown for the Drogenstammtisch and to an extent the planning cells, the very fact that the CFP is situated within civil society, rather than being an adjunct to the state, has helped to increase legitimacy, both with the public and partly with state officials. And as the literature on public participation has shown, a close association with the state is no guarantee that the views of the public will be more closely listened to. Targeting the Community Within post-war Western democracies, public involvement in the detail of public policy decision making has been the exception rather than the rule. The central communicative bridge between state and individual has been focused on the public meeting and the opinion poll, which have in the main be used as ad hoc measures to assess levels of public disquiet. This has left the traditional pluralist system as the mainstay of the policy process, based as it is around formally organized groupings within civil society. And such systems remain at the core of European public policy-making, despite being challenged on the grounds that they are focused on activists who cannot necessarily be said to represent the views of non-active members of the community, hence community-wide

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legitimation cannot automatically be sought (Moyser et al. 1992). This in turn has impacted upon politicians, who have viewed declining public involvement at the ballot box, alongside this challenging of the pluralist system, as constituting a significant threat to the legitimacy of liberal democracy itself. Politicians and administrators alike have now sought to reorientate the focus of the policy process away from the activist and towards the wider public. This trend has been evident in each of the case studies presented in this book. In a number of examples this has involved a move away from the idea of the group or community to the individual, where targeting the individual has been seen as the easiest means of circumventing pre-existing groups which are, it is argued, populated at least in part by self-selecting activists. In some cases the individual has remained the focus for the public involvement strategy, be that through the provision of vouchers for nursery places or through the targeting of individuals in the choice questionnaire. In other cases there have been attempts to reconstitute policy communities, such as the British health panels or the German planning cells. Shifting the focus on public participation from the organized group to the public as a whole, raises a number of important questions. Firstly, on a purely practical level one needs to consider the Schumpetarian contention that the general public lack the motivation, knowledge and ability to play a meaningful part in the policy process (Held 1987). On the first count, the findings from this book point to high levels of public motivation. The response rates for the choice questionnaire were significantly higher than those for most postal questionnaires; and with the British health panels and German planning cells, evidence pointed to people being particularly interested in becoming involved in the policy process over a prolonged period of time. Similar findings were evident in relation to the knowledge and ability of people to grasp complex issues within a relatively short space of time. In the cases of the choice questionnaire, the planning cells and the health panels, members of the public were expected to absorb and reflect upon information and opinion within a matter of hours or days. This they were able to do, although it is of interest to note that in the detailed account of the planning cell process outlined in Chapter 5, Peter Dienel talks about the need for moderators and for systems such as the rotation of members within the small group setting, in order to avoid the generation of the hierarchies that are commonly found in more traditional pluralist systems. A second and in some ways more problematic issue raised by this focus on the wider public, concerns the role played by CFPs within the wider policy process, especially their democratic legitimacy and whereabouts it lies. This will be the focus of the next section. Public Participation and the Policy Process Given that such a significant effort is currently being put into developing new participative structures which seek to overcome the limitations presented by

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traditional organizations within civil society and by representative democratic systems themselves, one must try to establish what role these new bodies can and should play and where their legitimacy and power is being drawn. The starting point for this process must then be to question the extent to which any participatory mechanism is able to involve the public in the policy process in its widest sense. Put in simple terms, public participation must be concerned with the big picture as much as the policy detail. For this to be the case, the process of public participation should involve the public in determining what is to be the subject of any particular consultation process. Seen as a whole, then, the role that a participatory mechanism will play in the policy process will be directly related to issues of power and legitimacy. For example, with the reformed school board system in Denmark, the consultative structure itself is quite traditional, based as it is around a series of formal and informal meetings between teachers and parents. The boards have a statutory position in the Danish education system, in that they are required to be consulted on a range of issues relating to educational and pastoral issues. However, Sørenson has demonstrated that any formal power that may reside with the school boards is wholly dependent on the willingness of teachers to engage with the committee rather than circumvent or undermine it through other means. She also makes clear that, traditionally, school boards have only been concerned with issues secondary to teaching and curriculum development matters, where detailed involvement from inception to implementation would not affect the fundamentals of the schooling system. Even in cases where the school board may be in a position to address what may be termed more meaningful issues, Sørenson demonstrates well how the pre-existing universe of meaning militates against the possibility of genuinely discursive practice becoming established. At one level the choice questionnaire, citizens’ juries and planning cells offer a more progressive model of public involvement. In each case the mechanism is designed to deal with significant policy issues, quite often at the key stages of policy inception and development. However, with respect to public ownership over the process, they are best viewed as an imposed and somewhat artificial construct, for in none of the three cases do the mechanisms represent a conscious response to an issue raised by a particular community. They are perhaps best seen as sophisticated mechanisms for involving the public in the policy process, mechanisms which have in the main failed to involve the public in any discussion about if, when or how they should be used. This leaves them open to manipulation by politicians and administrators, who would be unlikely to introduce any mechanism without having first considered a fall-back position if it were to produce findings which did not broadly concur with their existing thinking. The position is not helped by the fact that the mechanisms usually operate on a snapshot basis; while the public may be involved over a matter of days, they are not directly involved in the progress of an issue in the period before or after their own direct involvement. Issues such as these highlight the problems associated with generating legitimacy for CFPs. Thus,

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while the public might well be currently demonstrating a declining degree of faith in the existing institutions of liberal democracy, they may well show little more enthusiasm for a series of largely advisory bodies. Advisory bodies may demonstrate the potential for a more inclusive and deliberative approach to policymaking, but often they lack even the semblance of legitimacy offered by a competitive electoral process. However, in the planning cell project, Peter Dienel does contend there is some evidence that the rigorous nature of the deliberative process undertaken by members of the general public does generate a degree of legitimacy for the process within the wider community. Yet while this in itself may be encouraging, such legitimacy will always be tempered by the fact that it is the state rather than the community which decides the agenda for these mechanisms and which ultimately decides what happens to their findings. The Drogenstammtisch, on the other hand, appears to have gained its legitimacy because it was viewed by all parties as an appropriate forum to debate the issues relating to the implementation of harm reduction facilities and because it was developed and owned by the community itself rather than state agencies. It is interesting that the Drogenstammtisch does not have any formal power, relying instead on the legitimacy that it gained from all sections of the policy community concerned with drugs policies in the area of Basel. However, even here the remit of the Stammtisch was to an extent constrained; the decision to introduce harm reduction facilities was not taken by the community, that being part of social policy legislation taken at municipal and state level. Nevertheless, the relative success of the Drogenstammtisch by comparison with statesponsored initiatives does bring into question whether the state should in future seek to lead the process of community consultation or whether it should in fact concentrate on responding more effectively to the community’s own agenda. In short, with the partial exception of the Drogenstammtisch, none of the mechanisms examined as part of this book can be said to have played a central role in the policy process. Nor have they been able to determine policy agendas, nor follow through a policy from start to finish. To an extent, then, the innovations have been developed in a policy vacuum, where innovation has gone no further than the consultative process itself. This contention is examined in more detail in the next section, which considers the relationship between these mechanisms and the representative democratic system. Innovations and the Liberal Democratic Process In the introduction to this chapter, I spoke about the mechanisms discussed in this book aiming to augment rather than replace pre-existing links between the state and the citizen. Yet the term “complementary forms of participation” does appear to imply the existence of a relationship with existing structures, although it may be hard to establish.

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Health panels, citizens’ juries, the choice questionnaire and planning cells appear to have no formal link to the wider liberal democratic system. Politicians often have little involvement in the commissioning of these mechanisms and do little more than receive their advisory findings. This is despite the fact they are often dealing with issues which might well form part of the local or even national political agenda. Besides, these mechanisms have mostly been initiated by the state rather than the community; and despite their increasing use, the public have not vocalized any desire to see CFPs used more widely or given more powers. Yet in Britain at least, the election of a Labour government in 1997 has resulted in CFPs being placed higher on the political agenda, with a recent government initiative on local government supporting their use as an adjunct to the electoral process. In some cases, such as the Drogenstammtisch or school boards, the nature of the local policy process means these bodies work below the level of pre-existing representative structures. Yet even here the question arises as to whether such bodies should have statutory powers and whether the public should have a role in determining their agenda. When seen as a whole, it would be wrong to deny there has been a significant change in how the state attempts to engage with the public. From the 1960s to the 1980s, state-citizen political dialogue was centred on mechanisms which represented a passive form of voice, such as the public meeting or the community forum. Involvement was limited and discussion and debate were kept to a minimum. Rarely if ever were such bodies accorded any statutory powers. The methods evaluated in this book represent in part the state’s response to the failure of these earlier methods. There has been a recognition that public participation must be concerned with the big issues as much as the detail of implementation and that an attempt must be made to reach beyond traditional activists to develop more discursive and reflective practice. But voice options have not been the only developments in the sphere of statecitizen dialogue. Consideration has also been given to extending the provision of exit options within the public policy arena, such as with the Finnish case of nursery vouchers presented in Chapter 7. The next section considers the argument that exit offers a degree of real or meaningful empowerment, something which cannot be found in the five voice options in this book. Voice and Exit: A Matter of Balance? Hirschman (1970) spoke about the need for substantial voice underpinned by a minimal amount of exit. This book has examined only one example of exit, the nursery voucher programme in Finland, although several of the other initiatives do contain elements of exit. For example, the Danish school boards operated within the context that under certain circumstances a parent was able to change the school of their child if they wished, while the very success of the Drogenstammtisch was underpinned by the knowledge that its members could withdraw from the process at any time. However, what was unique about the

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nursery voucher scheme was that a central aim was to make exit possible, although even here one must question whether there was a meaningful sense of exit. In reality, what the vouchers allowed was a greater degree of choice over where to send one’s children. The scheme was concerned with generating a range of entry points rather than enabling exit, although a wider choice should also mean that exit itself becomes easier. The voucher scheme succeeded in as much as it resulted in a greater number and wider choice of nursery places becoming available within a relatively short space of time. So did the scheme generate any social disbenefits and could a voice mechanism have been used to achieve the same ends? The author himself found that, in the short term at least, the system did not increase inequality. He also found that voice mechanisms were if anything more sophisticated in those nurseries developed within the private sector than within the state sector, and remember that the voucher scheme as a whole was subject to scrutiny by politicians at both a local and national level. Yet in the long run one is still left with the problem that exit is more likely to benefit the most affluent, articulate and confident sections of society, and more fundamentally, choice based on issues of quality rather than say pedagogy will by its very definition mean that others will be more likely to receive a poorer service. In relation to whether more developed voice mechanisms would have enabled policy-makers to recognize and respond to changing patterns of demand, this is obviously a difficult question to answer. But one thing appears certain, for this to have been possible would have required voice mechanisms focused on the policy process at a level much higher than normal. Alternatively one could leave exit as a restricted method of last resort, or as a means to provide a level of service substantially above a recognized minimum for the general population. Whatever the case may be, the Finnish study has demonstrated how the introduction of the exit option can lead to an increase in service responsiveness in a manner and within a timescale that equivalent voice mechanisms may find difficult to match. Concluding Thoughts Two things can be said to separate out current developments in public participation from those of the 1960s, 1970s and 1980s. The first is the commitment to focus public involvement on a vision of the public which reaches beyond the activist into the wider community. The second is the commitment to involve people in a way that allows for a greater degree of reflection and deliberation. These changes have been driven on the one hand by a desire to provide cheaper and more efficient public services and on the other by a concern that traditional systems of participation were falling into disrepute. The results have been piecemeal. Public consultation remains an issue which those working in the public sector appear increasingly concerned to address. However, it has been more difficult to establish examples of substantive change

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that have taken place over the last few years as a result of using a CFP, and a number of important issues remain unanswered. In particular, if the public sector is committed to a meaningful engagement with the public, it must close the gap between innovative mechanisms, such as planning cells and citizens’ juries, and the relevant policy process. This will involve making the policy process more transparent, by ensuring that the manner in which issues are chosen is both clear and open, plus the dissemination and implementation of any findings. It will also involve attempting to establish the legitimacy of the CFPs within the population as a whole, which in itself may present a significant challenge. Such legitimacy will not be forthcoming if the state attempts to colonize the participative process. The state must help CFPs to be developed within civil society, rather than seeking to control both the participative mechanism and the policy agenda. In conclusion it can be said that public participation has undergone significant changes over the last ten to fifteen years. Engagement with users or the community at large used to be limited to ad hoc public meetings at one end of the spectrum and highly structured engagement with organized sections of the community at the other. But recently there has been a proliferation of approaches, many of which have sought to engage a broader representation of the public through the use of more discursive methods. The piecemeal nature of this change makes it difficult to establish whether it represents a significant or substantial shift in public policy-making. What can be said is that the systems reviewed in this book have shown how the public is willing to become involved in the policy process beyond the level of the ballot box. They have also shown that in using more discursive forms of participation, a more informed and considered input can be gained. This in turn can aid policy development and implementation, generating a greater level of ownership over the policy process as a whole. It remains to be seen whether these initiatives can move from the periphery to the centre of the policy process, whether they can become as accepted and valued a civic act as taking one’s place on a legal jury. References Arnstein, S. (1971) “A ladder of participation in the USA”, Journal of the Royal Town Planning Institute, April, pp. 176–182. Burns, D., Hambleton, R., Hoggett, P. (1994) The Politics of Decentralisation: Revitalising Local Democracy. London: Macmillan. Held, D. (1987) Models of Democracy. Cambridge: Polity Press. Hirschman, A. (1970) Exit, Voice and Loyalty. Cambridge MA: Harvard University Press. Moyser, G., Parry, G. and Day, N. (1992) Political Participation and Democracy in Britain. Cambridge: Cambridge University Press. Offe, C. and Preuss, U. (1991) “Democratic institutions and moral resources, in Held, D. (ed.). Political Theory Today. Cambridge: Polity Press. Outhwaite, W. (1994) Habermas. Cambridge: Polity Press.

Notes on Contributors

Danielle Bütschi graduated from the University of Geneva in political science, where she was involved in research on social policy and the processes of opinion formation. She is currently responsible for participatory technology assessment procedures at the Swiss Science Council. Her books include Le Modèle Suisse du Bien-être (co-edited with Sandro Cattacin, Réalités Sociales, 1994), Le Questionnaire de Choix: le Raisonnement dans les Processus Démocratiques (L’Harmattan, 1999). Peter C.Dienel is based at the Bergische Universität Gersamthochschule Wuppertal. During the last 25 years he has played a central role in developing the planning cell system, both in Germany and abroad. He is the author of Die Planungszelle: Eine Alternative Zur Establishment-Demokratie (Westdeutscher Verlag, 1997). Therese Dowswell is a health services researcher and is an Honorary Research Fellow in the School of Healthcare Studies at the University of Leeds. She has a particular interest in policy relating to maternal and child health. Stephen Harrison is Reader in Health Policy and Politics at the University of Leeds Nuffield Institute for Health. His research interests are in both the macro-politics of health services (including financing and organization) and the micro-politics of professional/managerial relationships and public and user consultation. He is author and co-author of ten books and numerous other publications. Pekka Kettunen has worked as a Research Fellow of the Academy of Finland since 1994. He is currently working at the Åbo Akademy University and involved in several research projects, including a comprehensive comparative study on the Nordic welfare state. Dr Kettunen’s publications include Implementation in a Multi-organisational Setting (University of Turku Press, 1994). Daniel Kübler has a PhD in political science, is currently Research Fellow at the Swiss Federal Institute of Technology, Lausanne and Lecturer in Public Policy at the University of Lausanne. He has worked and published works on urban social problems and policy in Switzerland and Europe, as well as on drug epidemiology in Switzerland.

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Peter McLaverty is a Senior Lecturer in the Department of Politics and Public Policy and Director of the Centre for the Study of Public Participation at the University of Luton. He is the author of The Politics of Empowerment? (Dartmouth, 1996). Maggie Mort is Lecturer in Health Research at the Institute for Health Research, Lancaster University. She is completing a project looking at innovations in mental health care in primary care settings, as well as working with the NHS Executive (North West) Research and Development Support Unit. Recent publications include Mort and Harrison, “Healthcare Users, the public and the consultation industry” in Ling, T. (ed.) Reforming Healthcare by Consent: Involving Those who Matter (Radcliffe Medical Press, 1999). Eva Sørensen is Associate Professor at the Department of Social Science at Roskilde University. Her main area of research is democracy and local empowerment. She is currently involved in the research project “Democracy from below”, which is being financed by the Danish Research Council. She has recently published a book on “bottom-up” research methods entitled Samfundsforskning Bottom-up: Teori og Metode (Samfundslitteratur, 1998).

Index

accountability 13, 106–8 agency theory 33 airport construction 91 Allison, L. 43 Alternative Dispute Resolution 35 Anon 113 appropriateness, logics of 135, 136 Arblaster, Anthony 23 Arnstein, Sherry 27–9, 129, 130, 141 Asher, K. 10 Ashmore, M. 105

citizens’ juries 84–6, 98, 146 Conservatives 11, 13, 15, 24, 94 health care policy 93–6 health panels 65, 145, 147 Labour 3–4, 13–14, 15, 107n1 local government 3–4, 7–8, 15–16, 116 new public managerialism 11, 12–13 NHS 14, 93, 94, 98, 107n1 quangos 9, 15 school vouchers 118 bureaucracy, Weberian 2, 12 Burnheim, J. 83 Burns, D. 3, 9, 16, 24–6, 26, 27–9, 112, 118, 129, 142 Burrage, M. 132 Bütschi, Danielle 9, 18–19, 50, 67, 68, 71, 73, 142

Badie, B. 2 Baldersheim, H. 9, 110 Basel, Junkie Association 57–8 Basel Drogenstammtisch 54–61, 142, 146, 149 Beck, Ulrich 82 bed closures 102 Beetham, David 23 Bellamy, R. 29 Bienel, Peter 35 Bijker, W. 94 Bird, J. 33 Blair, Philip 7, 9, 14 Blaug, R. 35 Bobbio, Norberto 29 Bogdanor, V. 6 Bongardt, P. 84, 89 Bowie, C. 96, 101, 106 Bowling, A. 106 Bradford Health Authority 102 Britain central government 15 childcare 117

Calderdale and Kirklees Health Authority 96, 98 Calhoun, C. 33 Cambridge and Huntingdon Health Authority 96 Campbell, A. 71 car use questionnaire carbon dioxide emissions 71–2 information 74–6 policy alternatives 71 response rate 71–3 response variations 72–4 Cattacin, S. 9, 50 centralization, state 81 CFPs see complementary forms of participation Champagne, P. 64

156

INDEX 157

child benefit 116–18 Child Day Care Act 117 childcare Britain 117 marketized 122 by parents 121 vouchers 19, 111, 116–22, 122, 150, 151 see also nurseries childminders 117 choice 112–15, 120, 121–4 choice questionnaire 66, 67–71 deliberation/self-reflection 71, 71, 72–4 future use 76–8 holistic 76, 142 individualistic 76 information 68, 69, 74–6, 78n4 limitations 76 particularistic 142 random answers 74 response rates 71–3, 147 Cicourel, A. 101 CitCon 86–8 citizen participation 4, 22 choice questionnaire 78 control 27–9 Drogenstammtisch 59, 60 citizens active/apathetic 81–3 and consumers 13 empowered 125, 127 institutions 30 legitimacy of views 114 liberal democracy 80 public service involvement vii service users 15, 106, 112, 113, 132 citizens’ juries Britain 84–6, 98, 146 costs 100 power 103–5, 145, 146 public health panel 96, 97 US 84, 85 citizens’ reports 87–89, 90 Clarke, M. 4, 6, 8 client-contractor split 11 clients 132 collectivistic view 38, 65, 101, 142, 143 Cologne Town Square, planning cell 89

colonization of participative vehicles 54, 83 commissioning organization, planning cells 86 commitment to participation 101, 104, 147 Committee of the Regions 6 common good 78, 81, 91, 101, 112–14, 132 communication 30–2, 33, 58 community EU funding 6 involvement 48–52 networks 96–8 targeting 146–8 vertical/horizontal movement 143 community health councils 96, 107n4 community resistance harm reduction facilities 43–5 neighbourhood participation 52–4 public meetings 44, 45–8 violence 47–8, 55 commuter traffic report 90 competition 112, 113 complaints systems 14 complementary forms of participation (CFPs) 16, 141, 146, 147, 149–1 conflict resolution 35, 65 consensus 36, 37, 144–7 Conservatives 11, 13, 15, 24, 94 consumerism citizens 13 empowerment 39 exit 113 and local democracy 15 public good 112–14 voucher system 114–16 welfare 111–17 contracting out 10 control and participation 27 Converse, P. 64, 74 Cook, T. 71 Coote, A. 80, 85, 96 Cram, L. 6, 15 Cranil, M. 130, 131 credibility, participation 104–6 Crosby, T. 80, 84 Crosland, Anthony 5 Cruikshank, J. 65

158 INDEX

culture, empowerment 130 Cunningham, Frank 23 customers see consumerism Dahl, R. 65 Dalton, R.J. 106 Danish Union of Teachers 131, 133 day care for children see childcare Dear, M. 43 decentralization 8–10 Denmark 2–3, 125–8 Finland 3, 110–12 harm reduction facilities 56–7 school governance 128 decision-making in democracy 29 Drogenstammtisch 58 health care 102–4, 104–6 legitimacy 105 schools 128, 129, 130–2 utilities added up 68 deliberation choice questionnaire 71, 71, 72–4 collective thinking 101 democratic 64, 65–7 Drogenstammtisch 61 fostering 145 and information 96–9 planning cells 84–6 policy process 61 polling 66 self-reflection 71 small groups 66, 84–6 Swiss democracy 66–8 democracy vii, 23 consumerism 15 decision-making 29 deliberative 64, 65–7 Drogenstammtisch 58 empowerment 23–6 enabling state 60 and identity 36–8 liberal 7, 64–6, 80 participative 28–29, 106 public health panels 145 radical 28–29, 36 social 109

Switzerland 15, 66–8 user-led 15 Denmark decentralization 2–3, 125–8 education 127–32 exit/voice in school reforms 129 local authority reform 8, 12 municipal government 126 political reform 17 primary school system 127–32 privatization 10 school boards 148, 150–2 School Governance Act 129 self-governing institutions 126 state church 139n1 teachers’ trade union 131, 133 two-tier government 2–3 user-led democracy 15 voter participation 5 welfare state 132 Dienel, Peter C. 19, 83, 84, 86, 87, 90, 91, 149 Dimaggio, P. 130 Direct Action 35 Dirnbaum, P. 2 discourse ethics 28, 30–3, 35, 65 Dowswell, Therese 19, 95 Drogenstammtisch 54–5 action committee 56, 57 citizen participation 59, 60 decision-making 58 as deliberative process 61 democratic process 58 harm reduction facilities 55–6 holistic/collectivist 142 legitimacy/power 56, 146, 149 policy process input 58–9 drug policy, Switzerland 42–4, 51, 55 Dryzek, J. 35, 58 Dumfries and Galloway Health Council 96 Dyrberg, T. 33 Eckerberg, K. 15 economic recession 109–11 education 19, 105–7, 115–17, 127–33 Eisinger, P. 44 Eisner, M. 62n10

INDEX 159

Elcock, H. 8 electoral system v, vii, 3, 5–6 empowerment 39 citizens 125, 127 of consumers 39 and culture 130 democracy 23–6 exit/voice 25–7 parents 39, 128, 129–1 and tradition 134–6 enabling state 8, 51, 60–1 enquiries, method/outcome 100–2 environmental improvement 71–8 equity 32, 33, 93, 104 ethics of provision 93 EU (European Union) vii, 6 existence/being, identity 36 exit consumerism 113 Danish schools 150–2 harm reduction facilities 62n10 institutionalized 126 mechanisms 144 and voice 16, 25–7, 123, 129, 139n2 vouchers 150 extra-governmental organizations 9 face-to-face panels 97 federalism 2, 50 Finland Child Day Care Act 117 childcare vouchers 19, 111, 116–22, 122, 150, 151 decentralization 3, 110–12 economic recession 109–11 education 115–17 local authorities 12, 110, 116 marketization 122 Ministry of Social Affairs and Health 118 New Local Government Act 110–12 privatization 10, 11, 115 public expenditure 8 public policy reform 110–12 public service delivery 109 social democracy 109 telecommunications 11

Welfare Reform Movement 115–17 fiscal crisis 5 Fischer, F. 43 Fishkin, James 66 Flynn, N. 7, 8, 11, 16 Foucault, Michel 33 Fox, C.J. 106 free communes 9, 12 Freemantle, N. 95 Friedman, M. 7 funding, public policy 113 Gaebler, T. 7, 81 Gallop, George 64, 76 Garbe, D. 84, 86 Gaxie, D. 79n8 Geras, Norman 37 Germany contracting out 10 federalism 2 local authority reform 12 planning cells 19, 65, 80, 84–91, 145, 146, 147, 149 political reform 17 service users 14 Giddens, Antony 18 Glasser, T. 64 Goldsmith, M. 1 governance vii, 126 Greve, C. 126 Grunow, D. 2, 10, 14 guest workers 8 Gyford, J. vii, 3, 5, 6, 13, 16 Habermas, Jürgen communicative rationality 58 consensus 37 critique 33–4 discourse ethics 28, 30–3, 35, 65 enabling state 51 legitimacy 60 public debate 52 public involvement matrix 143 social equality 32, 33 Hablåtzel, P. 12 Halderman, T. 12 Hall, W. 9, 13

160 INDEX

Hampton, W. 5 Hannover 83, 90 Hardmeier, S. 15, 67 harm reduction facilities 42–5 decentralized 56–7 Drogenstammtisch 55–6 exit of citizens 62n10 neighbourhood feedback 44, 48–52, 59, 60, 63n12 nimby activism 18, 43–5, 62n3 and n4 public meetings 44, 45–8 Harrison, Stephen 19, 93, 94, 95, 105 Harvey, D. 5 Hayek, F. von 4, 7 headteachers and parents 137 health care community health councils 96, 107n4 coordination 104 decision-making 102–4, 104–6 marketization 93–5 policy 93–6 privatization 94 rationed 95, 96, 104, 143 waiting lists/bed closures 102 health panels see public health panels Healthwatch Panel 97 Heginbotham, C. 106 Heikkilä, M. 118, 120 Held, David 79n8, 80, 147 Helle-Nielsen, I. 133 Henig, J. 112 Hirschman, A. 16, 25–8, 62n10, 122, 129, 130, 139n2, 150 Hoff, J. 134 holistic view 38, 76, 84, 142–4 Hug, S. 8 Hugl, U. 2, 11, 12 Huissoud, T. 48 Hunter, D.J. 94

collective public involvement 80–2, 100 and deliberation 96–9 for planning cells 83–5, 87 information cards, choice questionnaire 68, 69, 74–6, 78n4 Ingram, David 32 Institute of Public Policy Research 96, 98, 107n3 institutions change 135–6, 138–40 citizenship 30 exit 126 private-public cooperation 126, 127 self-governing 126 universe of meaning 130, 131, 132 voice 126 instrumentalism 52–3, 84 Iredale, R. 86

identity 36–8 ideology and reform 17 individualistic view 38, 142 inequality of market system 112 information choice questionnaire 74–6

Labour government 3–4, 13–14, 15, 107n1 Laclau, Ernesto 28, 36–8 Lafferty, W. 15 Larsen, M. 131 Lascoumes, P. 43 legitimacy citizens’ views 114

James, O. 16 Johnson, N. 112 Jørgensen, T. 132 Joye, D. 48 Junkie Association 57–8 Kangas, O. 109 Kensington, Chelsea and Westminster Health Authority 97, 101 Kettunen, Pekka 19, 115, 116 kindergarten for participating parents 84 King’s Fund 96, 98, 107n3 Kitschelt, H. 44 Klages, H. 2, 12, 17 Klausen, K. 12, 115, 116 Knudsen, C. 130 Kriesi, Hanspeter 2, 5, 71, 73 Kristensen, N. 130 Kübler, Daniel 35, 44, 51, 142–4

INDEX 161

decisions 105 Drogenstammtisch 56, 146, 149 enabling state 60–1 Habermas 60 planning cell 89, 149 professional 132, 138 public involvement 149 Lenahan, C. 80, 85, 96 liberal democracy 7, 64–6, 80 lifeworld 30, 33 Lindblom, C. 94 living standards, Scandinavia 109 Local Agenda 21 15 local authorities 8, 12, 15–16, 110, 116 local government 3–4, 7–8, 15–16, 116 local income tax 8 Local Voices (NHS Executive) 94 locational conflicts 59–60, 62n2 see also nimby activism Løchen 17 Loffler, E. 2, 12, 17 Longchamp, C. 15, 67 Longley, M. 86 Maastricht Treaty 6 McCarthy, Thomas 35 McLaverty, Peter 3, 18 Major government 11, 13, 15 Malatesta, D. 42, 50 Manning, N. 16 March, J. 130, 135 marketization childcare 122 choice 112 Finnish welfare 122 health service 93–5 individual control 24 inequality 112 limitations 116 public services 22, 112 Markussen, I. 133 Marx, Karl 29 Marxism, 30, 36 maternity clinics 114 Mather, J. 106 Meehan, E. 85 Meehan, J. 33

Michael, M. 105 Miller, H.T. 106 Milner, H. 109, 110 Ministry of Social Affairs and Health, Finland 118 monopoly 26 Mort, Maggie 19, 145 Mouffe, Chantal 28, 33, 35, 36–8 Moyser, G. 81, 147 municipal government 126 National Health Service see NHS Neidhart, L. 60 neighbourhood commission 51–2, 53–4 neighbourhood feedback 44, 48–52, 59, 60, 63n12 neighbourhood participation 52–4, 62n9 Neijens, P. 66, 74, 78 Neocleous, M. 36 neoliberalism 4 Netherlands choice questionnaire 66, 74, 76 local authorities 8 New, B. 95 New Local Government Act 110–11 new public managerialism 7, 10–11, 12–13 new social movements 106 new steering model programmes (NSMs) 12 Newcastle and North Tyneside Health Authority 96 NGOs (non-governmental organizations) 9, 10, 11, 51, 52 NHS (National Health Service) 14, 93, 94, 98, 107n1 nimby activism 18, 43–5, 62n3 and n4 Niskanen, W. 4, 7, 8, 81 non-governmental organisations see NGOs North Tees Community Health Council 96–8 Norton, A. 1, 2, 3, 4, 9 Norway, voter participation 5 nuclear energy debate 66 nurseries municipal 117, 119–2, 123 pedagogical orientation 119

162 INDEX

private 119–2 see also childcare O’Connor, J. 4 OECD/PUMA group 16 Offe, Claus 29–1, 67, 143 oil crisis 4, 5 Olsen, J. 130, 135, 132 opinion polls 64–6, 66, 146 Osborne, D. 7, 81 Oulasvirta, L. 110 Outhwaite, W. 30, 143, 145 Page, E. 1 Päivähoitopalvelut, L. 117 Papadopoulos, Y. 15 parents childcare 121 choice of school 128–30 decision-making in schools 128, 129, 130–2 empowered 39, 128, 129–1 and headteachers 137 participation 134 role 133–5 and teachers 130–2, 134–6, 138–40 Parsons, W. 112 participation 18–19, 24–6, 152 citizens 4, 22, 27–9, 59, 60, 78 commitment 101, 104 complementary forms 16, 141, 146, 147, 149–1 and control 27 credibility 104–6 democracy 28–29, 106 education for 105–7 electorate v, vii, 3 health panel 99 instrumentalized 52–3 ladder of 129 mechanisms 144–50 neighbourhood 52–4, 62n10 parents 134 payment 83–5, 90, 99 planning cells 83 public relations staff 98 Switzerland 66–8

voters 3, 5–6 see also public involvement matrix participation entrepreneurs 98 particularistic view 38, 72, 142–4 Pateman, C. 106 payment for participation 83–5, 90, 99 Piller, Charles 43, 62n4 planning cells 19, 80 citizens’ report 87–89 commitment 147 cost 89, 90 deliberation 84–6 funding 90 future 90–2 implementation 87 independence 90–2 information 83–5, 87 legitimacy 89, 149 participation 83 policy-making 145, 146 in practice 85–89 process 82–6 programmes 86–8 policy process see public policy political reform 17 polling 64, 66 Pollitt, C. 3, 7, 8, 109, 110, 111, 115, 116 postal panel 95, 96 postal surveys 94–6, 99–1 Powell, W. 130 power 23–5, 33 Preuss, U. 29–1, 67, 143 primary school system see schools private-public cooperation 126, 127 privatization 10–11, 94, 115 professionals autonomy 132–4 legitimacy 132, 138 provision, ethics of 93 public choice theory 7, 8, 24, 39 public consultation 52, 100, 152 public expenditure reductions 7, 8 public health panels 95–9 accountability 106–8 advice/decisions 102–4 choosing members 99 commitment 147 democracy 145

INDEX 163

educative 106 evaluated 97 exclusions 99 policy process 65 public involvement matrix 105 questions put 102 public involvement 48–52, 80–2, 82, 100, 148–50 see also participation public involvement matrix 22–4, 37–39, 72, 105, 141–5 public meetings 44, 45–8, 59, 146 public participation see participation public policy access 113 funding 113 new social movements 106 process 61, 65 reform 5, 13–16, 110–12 standards 113–15 public relations staff 98 public sector 8, 14, 111–13 public services citizens’ involvement vii delivery 109 efficiency 115 enabling state 8 market model 22, 112 paternalism 24 provision 11–12, 24, 112 quality 120 public sphere refeudalized 52–3 quality of services 120 quangos 9, 15 questionnaires 19, 96, 100 see also choice questionnaire radical democracy 28–29, 36 Randall, V. 117 rationality 33, 58, 145 rationing of health care 95, 96, 104, 143 Ray, L. 31 reciprocity 29–1 regional inequalities, childcare 117 Reich, R. 65

Reinventing Government (Osborne and Gaebler) 7 Rhodes, R.A.W. 106 Richardson, J. 6, 15 Ridley, F. 16 risk society 82 road construction 91 Rose, N. 106 Rothstein, B. 109, 113, 114 Rothwell, S. 109, 110, 115, 116 Rüegg, E. 43 Salminen, A. 109, 114 Salmon, C. 64 Saris, W. 66 Scandinavia free communes 9, 12 freedom of choice 113 living standards 109 political reform 17 welfare 109 Scharpf, Fritz 60 Schlosberg, D. 35 Schmitt, Carl 36 school boards 131, 143, 148, 150–2 school councils 128 School Governance Act 129 schools decentralization of governance 128 exit/voice 129 parental choice 128–30 parental decision-making 128, 129, 130–2 public/private sector 127 segregation 112 vouchers 118 Schou, B. 126 Sciarini, P. 8 Sehested, K. 131, 132, 133 Self, P. 24 self-interest 65 self-reflection 71, 71, 73, 142 service users 14, 15, 106, 107n2, 112, 113, 132 services accessibility 104 provision 24, 112

164 INDEX

rationed 95, 96, 104, 143 standards 114 see also public services; welfare services Sharpe 1 Simonen, L. 116 Singleton, V. 105 small groups, deliberation 66, 84–6 social equality 32, 33 social welfare, Scandinavia 109 Somerset Health Authority 97, 98 Sørensen, Eva 19, 126, 130, 131, 134, 136, 148 speech, illocutionary/ideal 30–2 stagflation 4 Ståhlberg, K. 9, 12, 110, 115, 116 standards, public policy 113–15 state centralization 81 enabling 8, 51, 60–1 provision of services 24, 112 voluntary organizations 126 Stewart, J. 4, 6, 8, 104 Stoker, Gerry vii, 3, 7, 14, 48 Strehl, F. 2, 7, 8, 11, 12, 16 subsidiarity 6, 9 survey costs 100 Susskind, L. 65 Sweden local democracy 14–15 local income tax 8 maternity clinics 114 Switzerland community protest 43–52 democracy 15, 66–8 drug policy 42–4, 51, 55 environmental improvement 71–8 federalism 2, 50 guest workers 8 NGOs 9, 50, 51 participation 16 privatization 10–11 public sector reform 8 public service provision 11–12 questionnaires 19 transport policy debate 71–2, 79n6 voter participation 5 see also Drogenstammtisch

talkback panel 96 teachers and parents 130–1, 134–6, 138–40 role 132–4, 136–9 trade union 131, 133 see also professionalism Tees Health Authority 96 telecommunications 11 Telephone of the Future 90 Thatcher government 11, 15, 24 think tanks 107n3 Törmä, S. 118, 120 Torstendahl, R. 132 Townsend, J. 37 trade unions, Finland 118 tradition, empowerment 134–6 transport policy, Switzerland 71–2, 79n6 Tullock, Gordon 24 two-tier government 2–3 universe of meaning 130, 131, 132 US citizen participation 27 citizens’ juries 84, 85 segregation in schooling 112 user boards 38, 39 user groups 106, 107n2 see also service users Villadsen, S. 5, 10, 12, 17 violence 47–8, 55, 82 voice and choice 121–4 consensus 144–7 and exit 16, 25–7, 123, 129, 139n2, 150–2 institutionalized 126 mechanisms 144 voluntary organizations 126 voter participation 3, 5–6 vouchers childcare 19, 111, 116–21, 122, 150, 151 consumerism 24, 114–15 exit option 150, 151 school 118

INDEX 165

waiting lists, health care 102 Waldegrave, William 13 Walsh, K. 111 Wälti, S. 43 Walzer, M. 33 Warnke, G. 33 Warrington Community Health Council 97 Weber, Max 2, 12 Webler, T. 86 Weir, S. 9, 13 welfare dependency 24 Welfare Reform Movement, Finland 115–17 welfare services 109, 111–17, 122 welfare state, Denmark 132 Widdicombe Report 6 Wilks, S. 8 Wistow, G. 94, 95 Wuppertal University 86 Young, I. 33 Young, S. 105 Zaller, J. 74 Zukin, C. 64