Symbolism is always important. How disappointing, then, that party managers from both sides of the Commons are said to have rejected proposals to modernise the debating chamber. Leaving aside pressing constitutional issues, parliamentary weakness and executive dominance, cramped quarters are known to encourage aggression in rats - let alone honourable members.

Does it really make sense in so-called cool Britannia to have a chamber where opposing parties are separated by sword's lengths, where members have nowhere to put their papers, and where precious time is wasted herding them through lobbies when voting could be done electronically by pressing a button?

To a population in recovery from the traumas of the second world war, restoring the pre-war structure may have conveyed the right messages of stability and continuity. But the 21st century House of Commons would surely be better off moving into a new horseshoe chamber. We would benefit enormously from being part of a more efficient democratic process.

So when the BBC is cutting back its local government correspondents and shifting parliamentary coverage off mainstream radio wavelengths, it is timely that that influential think-tank, the Institute for Public Policy Research, has been awarded£93,000 of lottery money to fund a new project aimed at involving ordinary people in making the policy decisions that affect their lives.

Its public involvement programme (PIP) brings together a group of collaborating organisations, including the King's Fund, the Local Government Management Board and Birmingham University's school of public policy. It will run initially for two years.

As pioneers of the citizens' jury model in the UK, the IPPR soon found out that, contrary to received wisdom, members of the public were ready and willing to take part in decisions and capable of addressing complex policy questions.

The audience at the PIP launch heard, for example, how a Walsall health authority jury debating priorities for palliative care rejected the four proposals it was offered and commissioned its own independent expert to put forward alternatives.

But the IPPR has also warned that juries are not the only model, and advises authorities to be aware of other options. It says purpose should be matched to method, and urges that all public involvement exercises should include experts, interest groups, service users and citizens. Many of the issues are aired in a useful new publication.

1And in future the PIP project will act as an information resource, assisting the exchange of information, ideas and practical experience, and promoting informed debate.

While analysts watching trends in health policy and management across Europe have detected a seemingly universal shift towards a higher profile for patient and consumer involvement at all levels, healthcare is still acknowledged as the sector with the greatest democratic deficit. Hence rebuilding public confidence is a major theme of The New NHS white paper.

Launching the PIP programme, IPPR deputy director Anna Coote claimed that democratic accountability had been undermined by new forms of public sector management and control, introduced in the name of market efficiency by the previous government.

She said that trusts, HAs and other agencies taking difficult decisions had trouble in communicating effectively and in sustaining the confidence of the public, while citizens were increasingly inclined to be cynical or suspicious about the motives and abilities of those who made decisions on their behalf.

But Ms Coote went on to argue that involving the public effectively could help build confidence in the decision-making process, improve the quality of decisions and develop consensus around controversial local issues - sentiments all echoed by Birmingham University's veteran local government guru, John Stewart.

Professor Stewart also emphasised that democratic practice must involve interaction. Opinion polls reported uninformed public views, he pointed out, and stressed the need to use a repertoire of techniques, as well as the importance of investing in planning strategy and follow-up before and after any exercise is undertaken.

Of course, there are dilemmas. Democracy is not cheap, and what happens next? How can experiences of building trust and achieving common ground be extended and sustained in future? Then there is the burning question of who sets the primary agenda. As one speaker said, agencies should be careful not to either load or lead the debate.

In a paper for a newly-published IPPR reader on social policy and social justice, Anna Coote and Professor David Hunter remind us it is always easier to diagnose a problem and offer a prescription than to ensure effective treatment.

Change has financial implications, while vested interests will fight hard to maintain the status quo.

The report about retaining the present Commons chamber was rapidly rebutted the day after it appeared. No decisions have been made so far, apparently. But when the white paper urges the NHS to be responsive and accountable, it is not encouraging to hear that the NHS Executive is holding a series of closed seminars for invited experts and excluding independent consumer representatives.

There is no need to spell out the symbolism of that. As previous official debates on public involvement have been characterised by intellectual laziness, old boy networks, and more than a dash of time-wasting tokenism, radical thinking is urgently needed. That might even include asking for public accountability from the Executive itself.


1. Delap C. Making Better Decisions: report of an IPPR symposium on citizens' juries and other methods of public involvement. London: IPPR Monograph, 1998.

2. Franklin J (ed). Social Policy and Social Justice . Cambridge: Polity Press, 1988.