Plan de tabulación de la información y análisis de resultados

Analysis was performed on full transcripts using an a priori framework based on the research questions. The transcripts were read, re-read and annotated manually. Relevant quotes from each manuscript were selected and copied to an excel spreadsheet containing the framework headings/themes which acted as supporting evidence to the analysis and interpretation of the data. Names were omitted from the quotes however the committee they were a member of and their role within that committee were included. This is to highlight if there are any differences/similarities between the two committees and types of committee members. Professional roles were known to the researcher but were not included in the quotes to protect anonymity. The framework was adapted inductively as the analysis continued as broader

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themes were identified. Individual responses which did not fit within the framework were noted in the spreadsheet to ensure that any important aspects were not missed, even if not arising as a common theme. Table 4.3 is the coding framework that was used to analyse the interviews.

Table 4.3 Coding Framework for Interviews

General / Deliberative Democracy

Centrality Density and Betweeness Other Type of evidence presented by individual Domination of type of evidence presented Networking – Macro Deliberation Involvement in original guidance (NSP only) Skills required to participate in the process Respect Inclusiveness of process / representation NICE selection (why) Formality of process / Feelings of environment created Benefits of inclusive deliberation

Skills of the Chair

Evidence of influencing the process Challenges with a deliberative approach Challenges associated with including different types of evidence in the process Transformation of preference 4.4 Conclusion

This chapter has discussed the main data collecting methods that was used to address the research aims set out in chapter one. Applying the DQI framework to samples from the selected PHAC meetings provides a deliberative quality measure allowing an insight into how respectful the process is in relation to listening and the type of language used by committee members. It also provides an opportunity to explore whether participants in the committees

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provide well-reasoned and justifiable positions and arguments and if there is any change in relation to preference or positions occurred. The measurement tells us the overall quality of the deliberation within selected PHACs in NICE and to assess whether the deliberation is similar to type I or II deliberation.

It is however anticipated that due to the structural conditions and of the PHAC meetings and the type of participant involved in the meetings, that the discourse will be dominated by type I deliberation and as consequence be defined as an exclusive rather an inclusive process. It is therefore important to also explore if any deliberation outside this micro process occurs and if these discourses are connected. The interview data will provide this opportunity.

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Chapter 5. The Quality of NICE Deliberation in PHAC Meetings

5.1 Introduction

The first part of this research involves measuring the quality of deliberation occurring in NICE PHAC meetings. This chapter will present the DQI data from two NICE public health guidance development processes. The NICE data will provide insights into the type and quality of deliberation that emerges from this epistemic community. In the PHAC meetings, deliberation took place in a structured, formal and exclusive setting between participants that were mainly experts in the medical profession. This is very much in line with the

characteristics of micro deliberation which is also structured and formal. It is therefore expected that the data will be similar to micro deliberation as defined by Hendriks (2006).

In this chapter interview data will be used to support the NICE DQI findings adding some interpretation to the data. Data from other studies will be used to shed some light on the quality of NICE deliberation in the PHAC meetings rather than being used as a direct comparator.

This chapter will discuss each DQI measure in turn. The measures which have been included in this analysis are; the nature of a speech act which explores the frequency of interruption,

respect which is interested in the frequency of respectful listening, foul and respectful

language used during deliberation. Force of the better argument measures the frequency of position change occurring in PHAC meetings and level of justification measures to what extent a speaker gives complete justifications for their positions / arguments. Lastly, the content of these justifications is measured including frequency of reference to the common

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Two NICE PHAC meetings held in London were observed and recorded (vitamin D and Needle Syringe Provision). Samples of the deliberation were coded using the DQI in order to measure the deliberative quality emerging from the PHAC meetings. This is an original study applying the DQI to PHAC meeting. There are no studies available which explore an epistemic community similar to NICE using the DQI. Due to this, a number of different studies have been selected to help make sense of the NICE data. The studies are used to get a clearer impression of the quality of deliberation in NICE and are not being used to make direct comparison. Direct comparison was not possible as the studies focused on different issues, participants of deliberation, political systems and time-scales. However they do help provide some meaning to the NICE data given the absence of direct comparative data. The studies which have been selected will be briefly discussed and the reasons for selection outlined.

Citizens (Belgium) – Caluwaerts and Deschouwer (2013) conducted nine deliberative experiments based on the topic of language and the division between Dutch and French speaking citizens in Belgium. This was an area of increasing deep societal cleavage. The study focuses on the involvement of citizens in deliberation and if they undermine

deliberative quality. It also questions if strong decision making rules further impact on quality. A total of eighty-three participants were involved. The study has been included as a comparison because the participants were ordinary citizens. In the NICE PHAC meetings lay citizens could be present. Participants in the study were selected using a heterogeneity

sampling method so there was variation in relation to gender, age and education. Deliberation was staged across three rounds lasting between a few minutes to one hour and thirty minutes with decision making occurring in the second and last round. No briefing material was handed out, moderators did not intervene and participants filled out questionnaires before and after

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the study. Discussion topics were formulated in a broad way. This is quite different from the NICE set-up which was formalised, structured and heavily facilitated by a chair. The findings suggest that confrontation amongst citizens does not undermine deliberative quality. This study will be used to provide insights into the quality of citizen’s deliberation. It will be used to assess if the deliberative quality is similar or different to committee members in an

epistemic community.

Parliamentarians (U.K) – This study was conducted by Steiner, Bachtiger, Sporndli and Steenbergen (2004) and has been selected as an example of parliamentarian deliberation. The study applied the earliest version of the DQI to parliamentary debates (plenary and committee sessions) in Germany, Switzerland, UK and USA. UK data has been selected from this study. Participants involved in the UK study were Members of Parliament. This data provides opportunity to explore the deliberative quality of parliamentary discourse and bench mark this against the NICE deliberation highlighting any similarities / differences between NICE committee members and parliamentarians in relation to how they deliberate and the quality of deliberation. Parliamentarian deliberation is often described as being elite or expert deliberation. This study has been included as it provides examples of elite or expert

deliberation which is an expected outcome of the NICE deliberation given the type of

participants (expert) deliberating and the environment which they are deliberating in (formal / structured).

Parliamentarians (Switzerland) - The original parliamentary data discussed above was later re- investigated for the use of stories in plenary and committee debates in Switzerland.

Bachtiger et al (2009a) focused on data from two debates on a language law in the

constitution and on labor laws. Given that stories are a measure used in the new version of the DQI , it is important to include this case as a bench mark of assessing whether other forms

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of communication such as storytelling is used more often by one particular type of deliberator and if it is dependent on the deliberative environment for example, micro or macro sphere.

Not all studies outlined above will be used to compare every DQI measure. This is because frequency data was not always available in each study for all the measures used in this study. The DQI is a flexible tool and depending on the area of interest, different variables can be explored and reported. Table 5 outlines which study is used to shed light on the NICE data.

Table 5: DQI variable and study applied

Variable Study applied

Nature of Speech Citizen (Belgium)

Force of the Better Argument Citizens (Belgium)

Respectful Listening Citizens (Belgium)

Respectful Language Citizens (Belgium)

Level of Justification Citizens (Belgium) Parliamentarians (U.K) Content of Justification: Common Good Citizens (Belgium)

Parliamentarians (U.K) Content of Justification: Stories Parliamentarian (Switzerland)

The chapter will be structured in the following way. Firstly, the importance of each DQI variable will be discussed in relation to deliberative democracy outlining why the variables are an important standards to measure. For example, it is important to measure the frequency of respectful listening occurring in the PHAC meetings as this tells us if committee members are respectful to others and that committee members can engage in deliberation without being interrupted. Following this, data will be presented for the vitamin D and NSP samples

alongside relevant data from the other studies. This is so the NICE data can be bench marked against other studies in relation to the deliberative quality and environment. Since no other study has applied the DQI to the public health guidance development process there is no baseline to compare the quality. However, given that NICE are responsible for making complex decisions that affect many individuals, the NICE data requires some level of

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comparison in order to understand the quality of the deliberation that emerges from the PHAC meetings. The studies will be used for this purpose. Finally, reflections on the data will be discussed for each variable outlining the significance of the findings specific to NICE and also in relation to deliberative democracy and governance networks.

The data for each DQI measure will now be discussed beginning with the nature of the speech act which tells us about participation in the PHAC meetings.