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Introduction: priority setting, equitable access and public involvement in health care

Albert Weale (Department of Political Science, University College London, London, UK)
Katharina Kieslich (Department of Primary Care and Public Health Sciences, King's College London, London, UK)
Peter Littlejohns (Department of Primary Care and Public Health Sciences, King's College London, London, UK)
Aviva Tugendhaft (School of Public Health, University of the Witwatersrand, Johannesburg, South Africa and Priceless SA, Wits School of Public Health, Johannesburg, South Africa)
Emma Tumilty (Bioethics Centre, Department of General Practice & Rural Health, University of Otago, Dunedin, New Zealand)
Krisantha Weerasuriya (National Medicines Regulatory Authority of Sri Lanka, Colombo, Sri Lanka)
Jennifer A Whitty (Norwich Medical School, University of East Anglia, Norwich, UK and School of Pharmacy, University of Queensland, Brisbane, Australia)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 15 August 2016




The purpose of this paper is to introduce the special issue on improving equitable access to health care through increased public and patient involvement (PPI) in prioritization decisions by discussing the conceptualization, scope and rationales of PPI in priority setting that inform the special issue.


The paper employs a mixed-methods approach in that it provides a literature review and a conceptual discussion of the common themes emerging in the field of PPI and health priority setting.


The special issue focuses on public participation that is collective in character, in the sense that the participation relates to a social, not personal, decision and is relevant to whole groups of people and not single individuals. It is aimed at influencing a decision on public policy or legal rules. The rationales for public participation can be found in democratic theory, especially as they relate to the social and political values of legitimacy and representation.


The paper builds on previous definitions of public participation by underlining its collective character. In doing so, it develops the work by Parry, Moyser and Day by arguing that, in light of the empirical evidence presented in this issue, public participatory activities such as protests and demonstrations should no longer be labelled unconventional, but should instead be labelled as “contestatory participation”. This is to better reflect a situation in which these modes of participation have become more conventional in many parts of the world.



This work was generously supported by the Brocher Foundation in Geneva, Switzerland, where the workshop on “Improving equitable access to health care through increasing patient and public involvement in prioritisation decisions” was held in November 2015. The authors thank the Brocher Foundation for hosting and funding this workshop. Katharina Kieslich and Peter Littlejohns are supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London at King ' s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Aviva Tugendhaft is supported by funding to PRICELESS SA from the international Decision Support Initiative (IDSI) through the Bill and Melinda Gates Foundation, grant number 740671. The authors are grateful to the reviewers for their comments and suggestions on the manuscript.


Weale, A., Kieslich, K., Littlejohns, P., Tugendhaft, A., Tumilty, E., Weerasuriya, K. and Whitty, J.A. (2016), "Introduction: priority setting, equitable access and public involvement in health care", Journal of Health Organization and Management, Vol. 30 No. 5, pp. 736-750.



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