Health Board Elections and Alternative Pilots in NHS Scotland:interim evaluation report

1. EXECUTIVE SUMMARY
1.1 This is the interim report on the pilot projects for expanding public participation in
NHS Board decision making. Four NHS Boards are in the pilot. Dumfries and
Galloway and Fife Boards are piloting partially elected health boards; their elections
were held and new members joined them in June 2010. Grampian and Lothian
Boards are piloting alternative ways of broadening board recruitment and
participation; their new members are joining them in late 2010.
1.2 The research team, based at the LSE and St Andrews University, conducted
electoral analysis and a large public opinion survey in the boards with direct
elections, and a large number of interviews in all four boards. This work is part of a
two-year evaluation. This interim report focuses on the preliminary results and
analysis of our quantitative research (especially a postal survey of the electorate
and survey of candidates). It draws on interviews where relevant and summarises
progress in the alternative pilots.
1.3 Our most important interim findings are:
- There was an impressive number of candidates - 130 between the two boards.
- The candidates were, broadly, healthy, male (71%), white (96%), resident in their
Board areas for more than five years, well educated (as many as 34.8% had
postgraduate qualifications in Dumfries and Galloway) and over forty (88%) if not
over sixty (52%).
- More voters in Dumfries and Galloway got information from the local press
and contact with candidates than did voters in Fife.
- Turnout was 22.6% of registered voters (26516) in Dumfries and Galloway,
and 13.9% of registered voters (39761) in Fife.
- In Fife, we have found no significant relationship between income and turnout. In
Dumfries and Galloway, we found deprived areas had lower turnout.
- We conducted a large sample postal survey of registered voters in the two
Board areas to inform our understanding of voting behaviour. With 3,000 forms
sent out in each board area and a response rate of 26% in Fife and 34% in
Dumfries and Galloway, our sample size compares well with most national
surveys.
- According to our survey, age was an important explanation of turnout. 89.1%
of voters in Fife were over 40 and 60.3% were over 60. In Dumfries and
Galloway, 91.3% of voters were over 40 and 61.1% were over 60.
- At first sight, few other attributes appeared important in explaining the likelihood
that somebody voted. Further investigation may uncover more complex
relationships.
- Turnout among 16-17 year olds was low, and significantly lower than
turnout among other electors. Ballots were returned by 12.9% of
registered 16-17 year olds (312) in Dumfries and Galloway, and 7% (311)
in Fife.
- Elected board members who returned our survey broadly fit the profile of the
candidates: healthy, without dependent children, over 40 (100%) and mainly
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over sixty (64%). A significant number had worked in the NHS, been elected to
local government, or served on Health Boards in Scotland.
- From an administrative point of view, the elections were generally perceived
as having gone well, though some interviewees suggested that concerns
about equalities and security might increase per-voter costs should there be
a national roll-out.
- Ongoing work includes further analysis of these results, observation of the
Boards, and interviews with key individuals.