Posts Tagged ‘democracy’

Why Change UK may turn out to be neither democratic nor a force for change

Lea Ypi explains why Change UK – The Independent Group appears to be aligning itself to a very different tradition of thinking about the relationship between citizens and representatives.

Modern democracy, wrote one of the great political scientists of the past century, is inconceivable – save in terms of party government. If that is true, when democracy is in crisis, a new political party might in principle offer opportunities for a way out. The newly created Change UK/Independent Group sees itself as a fresh political force breaking the way old politics works. It wants to occupy a space in the centre that traditional party divides are accused of having left void. It urges people to make change happen.

Except Change UK is not your standard political party. It has no manifesto, no popular base, no memory of struggles, victories and defeats. Instead of being a movement in search of political representation, it is a group of elected representatives in search of a movement. Instead of being the many represented by a few, it is the few urging the many to get involved.

Elections are arguably one of the most important moments in which a political group consolidates its principles and identity. It is how a new political force gathers the popular support that legitimises its demands for change. But Change UK is not that interested in elections either. If members were interested in popular mobilisation – campaigning to persuade fellow-citizens for the need to change, deliberating with supporters over principles – they would seize the first opportunity to confront their adversaries in by-election campaigns. Instead, they argue, fighting a by-election would “crush the birth of democracy”.

Change UK may not have a manifesto but it must at least have a vision of democracy. Except, on closer inspection, it turns out to be not very democratic. The birth of democracy, to return to their favourite formulation, is associated to rule by the many. In the Greek polis, the many ruled themselves by making direct decisions in the Athenian assembly. In modern societies, the many are too many and too diverse to speak directly for themselves. They speak through representatives in parliament. The extent to which the relation is democratic depends on the degree of proximity between representatives and represented. When that relationship is not subject to ongoing scrutiny it is not clear who the representatives speak for. Or what they speak about.

The more democratic a representative relation is, the more likely it is that the voice of the represented is heard in parliament (and not just on election day). Maintaining a close relation between professional politicians and the people who elect them is the only way to ensure that the voice of the many is continuously heard. For radical democrats, the purpose of democratic politics was to ensure that powerful people with more money, knowledge, and means to access public office were kept in check by the masses; that the few were constantly scrutinised by the many. To this effect they advocated a number of measures: mass membership in political organisations, imperative mandate, mandatory reselection, mechanisms of deselection of MPs, rotation in office, and so on. This is what democratic theorists call “the delegate” model of representation.

The Labour Party’s recent moves to expand membership along with proposals to change the relationship between members and MPs are part of this tradition. MPs are seen as only one of the links in the chain of democratic participation, they are by no means the most important one. Every MP and every decision made by them must remain accountable to party members at every step of the way.

Labour party leaders are often accused of authoritarianism. But if Labour really had been in the business of silencing criticism and undermining democracy, it should have discouraged rather than encouraged the delegate model of representation. The current Labour Party may have many flaws but a lack of democratic commitment is not one of them.

The same cannot be said about Change UK. The expressed refusal to fight by-elections and the arguments given to motivate that refusal signal its alignment to a very different tradition of thinking about the relationship between citizens and representatives. Members of Change UK insist that there is no reason to subject their views to democratic scrutiny since their values have not changed. But even if that were true, MPs are not selected only for the values they embrace but also for how they interpret those values in public life, and for the policy proposals they generate on that basis. A cursory look at CHUK’s statement of values in connection to particular public policies reveals sharp differences between those policies and the manifesto of the Labour party on the basis of which its former Labour members were elected. The only argument in their defence is given by a view of representation where MPs retain independence from their constituents: what is often called the trustees’ model of representation.

Historically, the emergence of the trustees’ model is associated to an explicitly anti-democratic attempt to isolate politicians from the power of the many. Its origins are in the explicitly moderate (we might say ‘centrist’ thought) of authors like Sieyes, Constant or Madison. The trustee model seeks to conceive of the representative relation as one in which political institutions are authorised by the masses but isolated from them. The argument is essentially an elitist, technocratic one: since modern life is about division of labour, only those with accumulated knowledge, expertise, and the right degree of wealth or skill are in the best position to make decisions about common affairs. The point of political authority is to guarantee the minimal amount of security that enables particular individuals to pursue their private affairs. The institutions that work best are, as in CHUK’s statement of values, those where “well-regulated private enterprise can reward aspiration and drive economic progress”. Disagreements of principle are reducible to disagreements of policy.

On the trustees’ model of political representation, once representatives are selected, their link with the represented is essentially a fiduciary one, like the link between a bank manager and the people who put money in a bank account. Once money is in the bank, you trust the bank managers to do their job. Once elections are over, you trust politicians to represent the people. While that model is much more pervasive in the electoral systems and political institutions of Western liberal democracies, the divide between professional politicians and ordinary people on which it is premised is arguably at the heart of what citizens resent the most in contemporary liberal politics.

To revive democracy, one has to depart from the trustee model of representation and consolidate the radical democratic one. Change is needed and change is coming. But it won’t come from a group of politicians whose democratic antipathies go so deep that they resent confrontation with ordinary citizens at every level, including in by-elections, the most basic level of representative accountability.

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Note: a shorter version of the above was first published in the New Statesman.

About the Author

Lea Ypi (@lea_ypi) is Professor of Political Theory at the London School of Economics and Political Science and co-author of The Meaning of Partisanship.

 

All articles posted on this blog give the views of the author(s), and not the position of LSE British Politics and Policy, nor of the London School of Economics and Political Science.

How involved is the public in changes affecting the devolved NHS?

Ellen Stewart, Angelo Ercia, Scott Greer, and Peter Donnelly compare how the public is involved in major service changes across the UK’s four health systems. They find some clear differences between the four systems’ processes, including the extent of central government oversight and guidance.

Of the issues that have dogged health politics since the creation of the NHS, the closure of hospitals has proved one of the most intractable. What decisionmakers describe as service ‘reconfigurations’ or ‘redesigns’, but many campaigners perceive simply as cuts, highlight central-local faultlines that have been evident in the NHS for 70 years. They outplay any other local issue in causing national political ructions; with local clinicians elected to Westminster, Stormont, and Holyrood on single-issue ‘save our hospital’ campaigns. Health policy debates have long exhibited impatience with such campaigns, and the result is that the bricks and mortar of the NHS is remarkably slow to change.

Recent research has argued that genuine processes of public involvement – how organisations consult and engage local populations in decision-making – may be key to enabling healthcare organisations to make the changes that they argue are clinically, and oftentimes also financially, necessary as health systems manage ageing populations with increasingly complex health needs. However what constitutes ‘meaningful’ (or ‘successful’) involvement processes remains contested.

In our research, we seek to understand how the NHS is involving the public in contentious service change comparatively, drawing on the remarkable natural experiment that is devolved health policy in the UK’s four health systems: England, Northern Ireland, Scotland, and Wales. It’s a task complicated by increasing divergence in both terminology and structures between these evolving systems, but one which provided intriguing insights into their priorities. All four systems have a stated, in most cases statutory, requirement for NHS organisations to involve the public in changes to services. However beyond that there are significant differences.

Public involvement and NHS England

England is both by far the largest of the UK health systems and also the one which has been most subject to radical reorganisation – or what has been described as redisorganisation – and fragmentation in alternating pursuit of competition or collaboration. Change – including closures – seemed most frequent in the English NHS compared to the other health systems. Central government actively seeks to distance itself from local service changes:

If your starting point here is who’s responsible for NHS service change … it doesn’t take place in this building [the Department of Health] anymore. Government, central government is not responsible for service change in the NHS. (Official, England)

As well as the Department of Health’s distance from change plans, NHS England, the behemoth agency-come-policymaking body, also emphasises that it advises but does not take responsibility for local decisions on approach. English policy guidance to local NHS organisations encourages involvement but in very general terms, and based on broad principles, not prescription.

Public involvement and the Northern Irish NHS

Northern Irish policy, by contrast, mandates a somewhat rigid and legalistic approach to public involvement. The focus is very much on pre-defined ‘consultation schemes’ which set out with some precision who will have a say and exactly how, and the approach to engagement was broadly, and with good reason, risk averse.

Say for example there was a service change and I thought I’ll have a focus group… we’re likely to be challenged… If it’s controversial and somebody doesn’t like our decision, which quite often happens, we would be challenged on the process. (NHS manager, Northern Ireland)

Not helped by prolonged periods without a functioning Government, hospital closures are vanishingly rare in the Northern Irish NHS, and even ostensibly minor changes to services provoke significant concern. As in the all the devolved system, Government civil servants play an active role in brokering solutions where controversy develops over proposed changes, but the overwhelming impression from our Northern Irish research was of frustration from both NHS staff trying to improve services and from campaigners, tired of repeated consultations on even very minor changes.

Public involvement and NHS Scotland

In Scotland, Health Boards redesign services with an extensive and prescriptive set of policy guidance which sets out how involvement should proceed. Perceived by some interviewees as excessively thorough, others felt that the detailed guidance gave Boards a degree of protection:

…incredibly nitpicky… it was absolutely exhausting… [But] you’re much more certain to be able to make the change if you’ve gone through the process, you’ve got a fighting chance. (NHS manager, Scotland)

A team of service change specialists within the Scottish Health Council (an NHS agency) provide advice and also assurance on the quality of involvement. Distinctively, current Scottish health policy additionally mandates the approval of the Minister in every service change which is deemed ‘major’. This contrasts sharply with the other three health systems where government politicians are generally shielded from the often febrile politics of hospital changes, and has kept hospital closures firmly on the Scottish political agenda.

Public involvement and the Welsh NHS

Welsh policy ambitions in this area are the most distinctive by some distance. Welsh health policy directs Local Health Boards to focus on continuous engagement with its population, with far less attention to a discrete process of consultation when a change is proposed. This emphasis on building trust, and therefore dialogue, between an organisation and its population seems closest to longstanding accounts of best practice. However this ambition for culture change towards transparent, responsive organisations was less evident in local practice, and had seemed to become embroiled in extant entrenched battles over particular hospitals.

Despite a proliferation of generic best practice guides and the availability of technical advice from organisations which cross national boundaries, processes of public involvement in contentious service changes were overwhelmingly shaped by factors endogenous to the four health systems. This supports other studies which have criticised organisational change management models for neglecting the highly politicised context in which UK healthcare organisations operate: put simply, in the UK, NHS change projects are deeply entrenched in their national politics. Taking an explicitly comparative approach to understanding British health politics – still too often assumed to refer only to English health politics – enriches debates on the relationship between the NHS and the British public. While calls for more comparable quantitative performance data are commonplace, qualitative comparison remains well-placed to handle the complexity of our increasingly divergent NHS(s).

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Note: the above draws on the authors’ published work in Health Economics, Policy and Law.

About the Authors

Ellen Stewart is Chancellor’s Fellow in Social Studies of Health & Medicine at the University of Edinburgh.

Angelo Ercia is Research Associate in Health Informatics at the University of Manchester.

Scott Greer is Professor in Health Management and Policy at the University of Michigan.

Peter Donnelly is Professor at the Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto.

 

All articles posted on this blog give the views of the author(s), and not the position of LSE British Politics and Policy, nor of the London School of Economics and Political Science.

Brexit and a “People’s Vote” – what would Wittgenstein do?

Calls for a second referendum on EU membership have been growing louder without, however, properly making the case for it. They fail to address the heart of the matter: how to show adequate respect for the democratic result of the 2016 referendum on EU membership whilst making the case for a new referendum. Ultimately, the case for a second referendum requires a compelling justification for challenging the first. The real question that the proponents of a people’s vote must confront is whether the democratic process can be suspended without undermining its legitimacy. They need to be able to square the ...
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