Section 2 – Deliberative Processes

Organising deliberations

Deliberation is a problem-solving group discussion that allows stakeholders with different backgrounds, interests, and values to listen, understand, potentially persuade, and ultimately come to reasoned, informed, and public-spirited collective decisions (Abelson et al., 2003). Common to all methods is the initial provision of information related to the issue at hand, the opportunity to discuss and/or challenge the information, and encouragement to express and consider viewpoints of different stakeholders before making a final decision or recommendation(s).

Deliberation can be expressed through different methods, such as citizens’ juries, deliberative forums, consensus conferences, etc. The method used can vary depending on participant selection (i.e., heterogeneous or homogeneous groups of people), the number of participants, the type of input needed, or the number of meetings (Abelson et al., 2003).

Aim

While the focus of deliberation may change throughout the project, the process of supporting deliberation should be consistent and underpin a participatory approach. Deliberation is undertaken to engage diverse stakeholders and gain their perspectives in key decisions. The overarching approach to deliberation (described below) should remain consistent.

Deliberative processes are distinguished by their focus on decision making within the:

• research team
• LIP Core and Management Teams
• community consultations

When to deliberate – Any time a decision would benefit most from engagement of stakeholders who will be affected by the decision (particularly the population that is vulnerable to access-to-care limitations).

When not to deliberate – There is no need to deliberate over managerial and administrative decisions – sometimes decisions just need to be made.

Approach

A deliberative process involves the following key components (more details regarding each are provided in the following sections):

1. Identifying a collective decision that needs to be made and framing questions;
2. Identifying stakeholders that need to be able to participate as peers in the decision making;
3. Identifying and providing the appropriate background materials to inform decisions;
4. Facilitating listening during the deliberative process itself;
5. Facilitating the process of reaching a collective decision; and
6. Facilitating learning about the completed deliberative process.

General guidelines (not rules)

Given that the aim of deliberative processes is to engage diverse stakeholders in key decisions, a large scale forum may not always be appropriate. It may be necessary for each LIP to apply processes that reflect the social and cultural reality of the context and participants. For example, multiple small deliberative sessions with homogeneous groups of stakeholders may be used to encourage the open exchange of ideas.

In addition, the selection of the deliberative approach must be made with feasibility and capabilities in mind! Cost and timelines are factors that can’t be ignored.

LIPs should keep clear records of their deliberative approach, including materials generated for each of the steps in the process as well as a record of how decisions made through deliberative processes were used in subsequent activities or in policy or practice.