Alice Miles
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When Patricia Hewitt was Health Secretary, she didn’t know what to do. So she commissioned a study, breathlessly described as the “biggest public consultation of its kind ever held in England”, to find out what people wanted her to do. It was to be a “major, large-scale deliberative event . . . beyond anything the Government has embarked upon before in the health field”. No fewer than 125,000 questionnaires were sent out asking people what they wanted from their NHS. Some 42,000 responded or attended regional events. A 1,000-strong “citizens’ summit” was then selected for a round-table discussion in Birmingham to discover “the people’s priorities” – and broadcast live on the web, they exclaimed! It was so unbearably exciting that not a single report was filed from it.
The project cost £1.25 million. It was conducted by Opinion Leader Research, an organisation run by Deborah Mattinson, who is an old friend of Labour. Today Ms Mattinson is the pollster for Gordon Brown, and we might call Ms Hewitt’s megafocus group a “citizens’ jury”.
So in the week that Mr Brown announced a series of citizens’ juries to give people a say in the big issues affecting their lives – the welfare of children, crime, followed by, oh no, “nine simultaneous Citizens’ Juries on the future of the National Health Service, one in each region, linked by video” (that one again) – let us examine what Ms Hewitt’s “citizens’ summit” was all about.
“Deliberative events aim to involve people in the big decisions that will affect their lives,” explained OLR at the time. “The whole point of a deliberative event is to allow people a voice, whilst giving them all the facts they need to reach a fully informed opinion.” So far, so exactly like citizens’ juries.
And what happened? The participants said they wanted urgent appointments available on the day when they needed them, routine appointments available at a later date of their choice, easy access to appropriate local services out of hours . . . just what people always say they want from the NHS. What they didn’t much like was the idea of competition, which was what the Government was actually proposing.
So one participant came up with another suggestion – after all, there had to be something concrete out of a £1.25 million exercise – and that was a “Health MOT”, one of a “set of options created by participants”, said the report. Nearly everyone agreed with that idea and it became the headline proposal when the Department of Health reported the findings.
And who, out of all those thousands of participants, suggested the “Health MOT”? An obscure interim report disclosed it to have been . . . Patricia Hewitt. Then, far from the “Health MOT” being the in-depth physical check that the “citizens” had liked the thought of, the Department of Health turned it in the end into a patient questionnaire. As far as I’m aware it’s still government policy; this was only a year and a half ago. Probably someone somewhere in Whitehall is beavering away at the multiple choice: “do you get headaches (a) often; (b) sometimes; (c) rarely; (d) never?” “Are they (a) at the back of the head; (b) at the front; (c) I don’t know doctor, it’s my knees, you see . . .”
It’s probably clear that I don’t believe the Government will allow a citizens’ jury to determine policy. The Government doesn’t even appear ready to allow citizens to decide what ought to be under consideration: ask a representative group what should be under discussion and they would probably suggest immigration.
Government can be very bad at defining what it is that actually ticks people off. It knows what people ought to be worrying about – the welfare of underachieving kids, Darfur, “opportunity” – but ignores what they actually care about: that an 11-year-old was shot dead by a teenager and a pensioner killed by a group of young boys, or that council tax is too high, or they got a speeding ticket while their burglary went uninvestigated; that a kid at school is disrupting the class and the head cannot chuck him out; that they had to fill in 50 pages of forms just to set up a playgroup; or that Eastern Europeans are taking their houses and jobs. It’s not the big picture Mr Brown needs to worry about, but these lots of little ones.
Team Brown sees politics as a clear political choice: left or right, Labour or Conservative. So do most of those in the political media class. But many voters see it differently – it’s about a feeling that things aren’t quite right, or that the people in power are failing to understand what it is that really bothers them. It’s not about knowing that a citizens’ jury has been set up to examine the issue, or a Speaker’s Conference is going to look at voter engagement. In fact, that knowledge probably makes things worse.
When Rhys Jones was murdered in Liverpool last month, Mr Brown should have gone up there. He didn’t, because he believes that highlighting crime simply plays into people’s fears of it, and crime is better talked down. Only yesterday did he appear to wake up to the fact that he needed at least to talk about it, with promises of new police powers, CCTV and extra patrols.
In one way it is a relief not to have a Prime Minister cashing in on other people’s sorrow, but that is not all that Tony Blair was doing when he leapt to embrace the latest victim. He was also telling the public: “I recognise that you care about this.”
In the past week, to the backdrop of reports of more and more teenagers arrested and questioned over Rhys Jones’s murder, Mr Brown fêted Nelson Mandela and unveiled a statue of him in Westminster, then wrote an article in The Times about how he was going to save Darfur. I’m not surprised he lost his poll lead.
It’s all very well to have a big heart, but sometimes a Prime Minister needs a small mind as well.

Alice Miles has been with The Times since 1999. She began as a Parliamentary Sketch writer before becoming a columnist, writing mainly on politics and national issues such as education and health. She won Columnist of the Year in 2007.
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Well said Alice Miles, but then again, when did a politician, let alone a Prime Minister, ever really listen to what is being shouted from the lower orders? These people become out of touch once they enter the rarefied atmosphere of the Palace of Westminster and from then until the next general election they are deaf as well as ignorant of the day-to-day issues that really affect the people of this nation. The latest quality of life survey should, at the very least, have elicited some comment particularly since we are the 5th wealthiest nation in the world but well behind much of the rest of the advanced, industrial world. For example the fact that we only have 4 beds per 1000 of population and do not feature in the top 40 countries; our per capita income is well behind much of Europe but the third highest for house prices; we now have some of the highest crime figures; and, we are the third highest destination for asylum seekers despite being a small island. Time someone got a grip.
Kenneth Armitage, Suffolk, England
Dear Alice,
I enjoy reading your articles and admire your forthright approach.
However, I feel that here you are misrepresenting the process that the Department of Health followed in order to gain people's views.
I was a member of the team in the Department of Health producing the Our health, our care, our say White Paper and I can genuinely say the consultation informed the document we produced. A good example is the focus on carers, which was driven by what people told us at the deliberative events.
You don't mention that although the Health MOT was proposed by Patricia Hewitt as an option to be voted on (endorsed by the public), this was following her listening to discussions and it was also suggested by several written consultation responses.
The trick with making the Health MOT work is that it needs to be targetted - if everybody had one a year then that would be 60 million appointments - hence the need to self assess initially through a questionnaire.
Peter Howitt, St Albans,
Yes alice, well done ! Have a house point.
RJA, Nottingham, England, UK
Gordon Brown, like every good Stalinist, believes the people exist to serve the state. So obviously when he comes up with "Citizen's Juries", he is not going to take the blindest bit of notice. It is just another exercise in Labour spin, paid for by our taxes to acheive nothing except massage the egos of deluded politicians like Mr Brown and his cronies.
Peter, London,
At last - Alice is saying what many of us think! A reality check is needed by politicians and less of their strutting about on a national/world stage posturing and parading their generosity and large horizons at our expense.Anyone would think they were spending their own money rather than the taxes they levy on us!
kay, leeds,
Get your facts right. The £1.25 million spent on a "citizens' jury", that produced no actual policies worth a carrot, probably cost us a lot less than the labour party manifesto and did less damage to the economy and my tax bill. Let's have a few more. They keep politicians harmlessly occupied and off the streets and let the rest of us get on with real life concerns.
KR, Stockport,
One wonders whethher the Government have a dedicated civil servant to read articles such as these and take a note of the comments written on the bottom. If not then they jolly well shoud do, and may I nominate myself as the right girl for the job?
Excellent article, these opinions ring true in my household.
Liz Scott, Hastings, E. Sussex
"When Rhys Jones was murdered in Liverpool last month, Mr Brown should have gone up there. "
This is absolutely the worst thing he - or any Prime Minister could do - tagging onto the coat tails of every shocking, emotional event makes the individual tragedies that strike merely the servants of politics. It does not show empathy on the part of Brown, just trivial and cynical bandwaggoning. We had 10 years of that with the egregious Blair.
We do not want any more of it.
Geoff H, Milnthorpe,
Tony Blair may have been telling the public âI recognise that you care about thisâ, but he didn't CARE that we care - like Brown now he was entirely indifferent to the public's concerns. Modern politics is not about righting society's wrongs, only about spinning oneself into favourable media reports. Ask yourself this - if you could make the PM really understand even one small problem, would he do anything about it? Of course not - small problems are small news.
Rosie, Upminster,
Finally, Alice Miles writes something worth reading. It had to happen eventually. Well done Alice. Thinking with your head not your bleeding heart for a change. Gold star.
tired and emotional, Londonistan,