COMMONS

What is a citizens’ assembly?

A citizens’ assembly is a group of people who are brought together to discuss an issue or issues, and reach a conclusion about what they think should happen. The people who take part are chosen so they reflect the wider population – in terms of demographics (e.g. age, gender, ethnicity, social class) and sometimes relevant attitudes (e.g. preferences for a small or large state).

Citizens’ assemblies give members of the public the time and opportunity to learn about and discuss a topic, before reaching conclusions. Assembly Members are asked to make trade-offs and arrive at workable recommendations.

Citizens’ assemblies, and other similar methods, have been used in the UK and other countries – including Australia, Canada, and the United States – to address a range of complex issues. A citizens’ assembly is currently taking place in the Republic of Ireland – established by the Irish Parliament – to address a number of important legal and policy issues facing Irish society. These have included equal marriage, abortion and the opportunities and challenges of an ageing population.

What did the Citizens’ Assembly on Social Care consider?

The Citizens’ Assembly on Social Care considered the question of how adult social care in England should be funded long term. This included issues like how much individuals should have to pay themselves, versus how much should be publicly funded. It covered adult social care for both older and working age adults.

Adult social care is the support provided to adults with physical or learning disabilities, or physical or mental illnesses. It includes support for older people, and also for some working age adults with disabilities or illnesses. The support could be for personal care (such as eating, washing, or getting dressed) or for domestic routines (such as cleaning or going to the shops).

Why hold a Citizens’ Assembly on Social Care?

Social care provision and funding has been the subject of numerous reports, commissions and Government papers over many years. Despite agreement on the urgent need for reform, this has not translated into action or consensus on how it should be achieved.

Ahead of the Government’s Green Paper, the Health and Social Care Select Committee and the Housing, Communities and Local Government Select Committee are holding a short inquiry to identify funding reforms which will command broad consensus, and which will enable the Government to make swift and tangible progress in this area.

Citizens’ assemblies have been effective in the UK and internationally at a) giving decision-makers a detailed understanding of informed public opinion on complex issues; and b) opening up the space for political consensus to be found.

Who ran the Citizens’ Assembly on Social Care?

The Health and Social Care Select Committee and the Housing, Communities and Local Government Select Committee commissioned the Citizens’ Assembly as part of their joint inquiry into the long term funding of adult social care.

The Assembly was organised by Involve – the UK's leading public participation charity, on a mission to put people at the heart of decision-making. Involve are experts in how to design, facilitate and project manage citizens’ assemblies, as well as other methods that enable the public to participate in decision-making.

Two charitable foundations – the Esmée Fairbairn Foundation and The Omidyar Network – also contributed funds, but had no involvement in the Assembly’s design or delivery.

How were the recommendations of the Citizens’ Assembly on Social Care be taken on board?

The Assembly’s recommendations fed into the joint inquiry by the Health and Social Care Select Committee and the Housing, Communities and Local Government Select Committee. The Select Committees’ Members considered them, alongside other evidence submitted to the inquiry, when deciding on their own recommendations for how adult social care should be funded. The Assembly’s findings will also be published separately on the Committees’ website.

Who were the Assembly Members?

The Citizens’ Assembly on Social Care was made up of 47 English citizens who are eligible to vote in UK general elections. The members were recruited with the help of ICM to be representative of the English population in terms of age, gender, ethnicity, socio-economic group, place of residence, and attitudes towards a small/large state. They included people with direct experience of social care for both working age adults and older people.

Stratification criteria

 

England population

Assembly members

Comparison

Age

18-34

28.60%

25.53%

-3.07%

35-54

34.10%

31.91%

-2.19%

55+

37.20%

42.55%

+5.35%

Ethnicity

White

86.30%

80.85%

-5.45%

Ethnic minority

13.60%

19.15%

+5.55%

Gender

Male

48.90%

51.06%

+2.16%

Female

51.10%

48.94%

-2.16%

Region

North

27.80%

21.28%

-6.52%

Midlands

19.00%

23.40%

+4.40%

East

11.10%

17.02%

+5.92%

London

15.60%

14.89%

-0.71%

South

26.50%

23.40%

-3.10%

Social grade

ABC1

53.20%

55.32%

+2.12%

C2DE

46.70%

44.68%

-2.02%

Big / Small state

Government should cut taxes

6.96%

10.64%

+3.68%

Neutral

40.22%

40.43%

+0.20%

Government should increase taxes

52.82%

48.94%

-3.89%

In order to encourage and support participation, Assembly Members were provided with an honorarium of £150 per weekend.

There was no option to directly apply to be a member of the Citizens’ Assembly as members were selected randomly (through a process called random stratified sampling) to ensure they are representative of the general public.

When and where did the Assembly meetings take place?

The Assembly met over two weekends (27th-29th April 2018 and 18th-20th May 2018) in central Birmingham.

What happened during the Assembly meetings?

At the first weekend, Assembly Members heard from expert contributors who together reflected the range of views on how adult social care should be funded. Assembly Members heard presentations from the contributors and spent time questioning them. They discussed what they said in small groups, identifying the issues and arguments that they felt to be most important.

At the second weekend, Assembly Members discussed what they had heard and reached a set of recommendations. To do this they worked through a series of exercises, involving small groups discussions, as well as some voting and ranking of options.

The weekends were led by professional facilitators and there were also facilitators on each table. It was their role to make sure everyone could be heard and felt comfortable, as well as to explain each of the exercises. Facilitators only explained and answered questions about the Assembly’s process – any questions about the issue under discussion (i.e. social care) got referred to the Assembly’s Expert Lead, Professor Martin Knapp from the London School of Economics and Political Science.

How did you ensure that the Assembly was accessible to everyone?

It is important, particularly on a subject such as social care, that a citizens’ assembly is accessible to everyone. This is ensured in a number of ways.

The costs of members attending the Assembly were covered in full, including providing travel, accommodation and meals. In addition, Assembly Members were provided with an honorarium of £150 per weekend in order to encourage and support their participation.

This both recognised the time that Assembly Members were giving up to take part and ensured that a diverse range of participants (e.g. including those on low-incomes, unemployed, with caring responsibilities, etc.) could participate.

The venue for the Assembly was fully accessible and all accessibility requirements of Assembly Members were taken into account. This included, where needed, providing materials in Braille or large print and sign language interpretation. The costs of carers, respite care and child care were also covered where needed.

The Assembly proceedings were carefully designed to enable the full participation of all members. Small group work ensured that all participants were able to contribute and had time to reflect and develop their own opinions, particularly those less confident in public speaking. The exercises and techniques that were used were specifically designed to support Assembly Members to engage with complex information and feel able to put their opinion forward, with no prior knowledge needed.

How did you ensure that the information Assembly Members received was balanced and accurate?

In order to ensure balance and accuracy, an Expert Lead was appointed to advise on the selection of expert contributors and the development of materials. The Expert Lead, Professor Martin Knapp from the London School of Economics and Political Science, is well respected for his knowledge and impartiality on the subject of social care.

In addition, an Advisory Panel supported preparations for the Citizens’ Assembly on Social Care. Its role was to help ensure that the Assembly’s materials were factually accurate, comprehensive, balanced and unbiased. The Advisory Panel Members were:

  • Caroline Glendinning, University of York
  • James Lloyd, formerly of the Strategic Society Centre
  • Kari Gerstheimer, Mencap
  • Raphael Wittenberg, London School of Economics and Political Science
  • Warwick Lightfoot, Policy Exchange

Who were the expert contributors?

Assembly members heard from a range of expert contributors, selected to cover the breadth of opinion on how social care should be funded.

Speaking on options for how any private financing (i.e. by individuals) of the system should work and views on the optimal balance between private and public financing, Assembly Members heard from: Anna Bailey-Bearfield, Care and Support Alliance; Dominic Carter, Alzheimer’s Society; Emily Holzhausen, Carers UK; Jim Boyd, Reform; and Simon Bottery, Kings Fund.

Speaking on options for how any public financing of the system should work and views on the optimal balance between private and public financing, Assembly Members heard from: Edward Davies, Centre for Social Justice; Jane Vass, Age UK; Jon Glasby, University of Birmingham; Mike Date, Mencap; Sarah Pickup, Local Government Association.

Speaking on the experience of using the social care system, Assembly Members heard from Tracey Lazard, Inclusion London; and two members of the public.

Image: Cade Hannan, Steamroller Productions