Inside information - When some consultees know more than others

One of the undoubted challenges facing those who organise consultations is that the target audience is very seldom homogeneous.

The nearest we may get to this convenient state is when a trade body consults its members; when the General Medical Council consults doctors, for example, or when the Arts Council consults Theatre Managers. Even then there are, of course, differences. A newly-qualified junior doctor’s perspective will clearly differ from one with forty years experience of general practice. In our Arts example there is, presumably, quite a difference between the Manager of Stratford’s new Royal Shakespeare Company showcase and the part-timers struggling to keep a local Rep theatre in one of our market towns. In short, all consultations have to assume that those who respond will do so from a vast range of perspectives and that some will know more than others. This also applies to the general public. It is a myth that everyone is equal in the information age, though their entitlement to a voice is most certainly identical.

So, we have well-informed, highly motivated consultees, eager to engage and most likely advocating their cause well before (and probably well after) the consultation period. And we have those who haven’t yet heard that their views are being sought, and/or do not yet feel sufficiently informed to contribute. This is why we allow a reasonable period of time for a consultation. It may not always need to be 12 weeks, but any proposal significantly affecting individuals or interests needs time to sink into the consciousness of stakeholders if the ensuing debate is meant to include both the slower-off-the-mark as well as the eager enthusiasts.

In fact one of the more frequent criticisms of public sector consultations is that they fail to capture enough of the views of the silent majority. The answer is that we can always research those people provided we organise ourselves to do so; it just needs some budget and some time. What foreshortened timescales ensure is that those who are most likely to make the biggest impact in the exercise are those with well-defined views or those with advance information about the forthcoming consultation – and how to influence it.

A good example was the BBC’s coverage of recently-announced plans to expand one of our Airports. It was, said the Reporter, a ‘surprise’, and so it may be for some local residents. But others, it seems, will have known of such plans for some months. Some will have had prior knowledge through involvement in permanent consultation machinery, such as a liaison committee, whose role is to discuss matters of common interest.

The moment general discussions crystallise into proposals that form part of a formal consultation – these individuals will be there – poised at the starting-gate, so–to-speak! No wonder they will dominate the early public debate; they are the ones with inside information. For the Airport project, the challenge facing the organisers of any consultation will be to widen the debate, and place as many other stakeholders as possible in a position of equivalent insight, so that a wider range of voices can be heard. That’s why they will need a suitably extended period of debate. A ‘quick-and-dirty’ engagement exercise would, in a case like this, play into the hands of opposition groups who will almost certainly organise themselves quickest.

Structured engagement channels exist throughout the public services and need careful handling. In Wales, Community Health Councils represent the voice of patients and the public – and have a formal engagement role on change proposals in the NHS and social care; in England, the current LINks – soon to be Healthwatch play a similar role, providing participants with privileged access to Managers taking decisions and obtaining advanced or better information and understanding of the facts.

Best practice thinking is that these channels of communications are excellent ways to develop change proposals, and to anticipate the impacts of various ideas. Co-production and co-design are rightly becoming popular. But there are pitfalls, and as the recent Royal Brompton Hospital Court case illustrates, option development processes have to be well-conducted, and Judges will intervene if they go wrong.

All of this means we have to be cautious when balancing the involvement of those who are ‘in the know’ against those who have had no previous exposure to the issues or the process. It is a little like (but not identical to) the distinction between the usual suspects and the seldom-heard. It takes skill and judgement, and requires a good understanding of current thinking in consultation best practice.

Trigger points

• Have you experience of consultations where those with inside information dominated the debate?
• Do you allow enough time for your consultations to reach a wider audience?
• For more about Structured engagement, see Topic 204; for more about the Silent Majority, see Topic 87. See also Topic 158 (What’s the significance of the Heathrow Third Runway decision?) – available to members via the website, and to non-members upon request.
• The Royal Brompton Hospital case will be considered in depth at the next Institute Key Issue Workshop on Legal Challenges to Consultations in Health & Social Care.

This is the 204th Tuesday Topic; a full list of subjects covered is available for Institute members and is a valuable resource covering so many aspects of consultation and engagement