Is there ever a circumstance when a statutory organisation can legally run a closed consultation only to the current users of a specific service and nobody else?
Yes, in principle, but the circumstances are very specific.
In employment scenarios, for example, it is common for the staff to consulted on matters that primarily concern their terms and conditions.
I appreciate however, that you are thinking here of a health service scenario where there is a duty to involve patients and public in service changes.
My first comment is that the idea of a ‘closed’ consultation is itself not straightforward. It is possible to target a consultation very precisely, and yet have sufficient public information available about the exercise as to enable a motivated member of the public to have access to and participate in it, and have his/her views considered.
When might such consultations be acceptable? In the absence of three ‘widening’ considerations, any of which might suggest a broader-based exercise.
- The likelihood of other members of the public requiring the same service. There are highly specialised services of immense importance to small numbers of people, and where the likelihood that the average citizen will require the same is infinitesimal, and where only the current users can reasonably be accessed. On the other hand, if the service is one where large numbers can be predicted as likely to become service users, and especially if certain groups have a higher propensity to require the service (eg maternity or, sadly, dementia), the wider consultation would be more appropriate
- Where resource or deployment implications might have an impact on other stakeholders. Changes do not always affect service users; they also impact service deliverers. So doctors and nurses, faced with changes in working practices, might wish to consider the extent to which they support those changes. Or maybe an organisation such as a hospital might need to reflect upon the implications of devoting more (or fewer) in-patient beds to one speciality and its impact on other clinical services. (If the organisation is itself the consultor, it makes it easier, but in reality, it might not be thus). In general, if there are lots of other legitimate stakeholders, the users-only consultation is less likely to be acceptable
Where there are public policy issues where the wider community should have a say. These are relatively infrequent, but do exist in difficult areas such as ‘ IVF services‘, ‘end of life’, ‘mental health’ and similar areas. One could extend this to the hard choices about very expensive drugs for very few patients – the kind of ethical issues that have to be dealt with by NICE. Wherever there is a genuine public policy issue – even to extending whether treatment XX is offered in Town A or Town B – it is likely that the ‘closed’ consultation is unviable.