Public involvement in health priority setting: future challenges for policy, research and society

David James Hunter (Centre for Public Policy and Health, Durham University, Stockton on Tees, 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)
Sophie Staniszewska (RCN Research Institute, Warwick Medical School, University of Warwick, Coventry, UK)
Emma Tumilty (Bioethics Centre, Department of General Practice & Rural Health, University of Otago, Dunedin, New Zealand)
Albert Weale (Department of Political Science, University College London, London, UK)
Iestyn Williams (Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK)

Journal of Health Organization and Management

ISSN: 1477-7266

Publication date: 15 August 2016

Abstract

Purpose

The purpose of this paper is to reflect on the findings of this special issue and discusses the future challenges for policy, research and society. The findings suggest that challenges emerge as a result of legitimacy deficits of both consensus and contestatory modes of public involvement in health priority setting.

Design/methodology/approach

The paper draws on the discussions and findings presented in this special issue. It seeks to bring the country experiences and case studies together to draw conclusions for policy, research and society.

Findings

At least two recurring themes emerge. An underlying theme is the importance, but also the challenge, of establishing legitimacy in health priority setting. The country experiences suggest that we understand very little about the conditions under which representative, or authentic, participation generates legitimacy and under which it will be regarded as insufficient. A second observation is that public participation takes a variety of forms that depend on the opportunity structures in a given national context. Given this variety the conceptualization of public participation needs to be expanded to account for the many forms of public participation.

Originality/value

The paper concludes that the challenges of public involvement are closely linked to the question of how legitimate processes and decisions can be generated in priority setting. This suggests that future research must focus more narrowly on conditions under which legitimacy are generated in order to expand the understanding of public involvement in health prioritization.

Keywords

Acknowledgements

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 are grateful to the Brocher Foundation for hosting and funding this workshop. Peter Littlejohns and Katharina Kieslich 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 author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Sophie Staniszewska is part funded by the NIHR CLAHRC West Midlands initiative. This paper presents independent research and the views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The authors are grateful to the reviewers for their comments and suggestions on the manuscript.

Citation

Hunter, D., Kieslich, K., Littlejohns, P., Staniszewska, S., Tumilty, E., Weale, A. and Williams, I. (2016), "Public involvement in health priority setting: future challenges for policy, research and society", Journal of Health Organization and Management, Vol. 30 No. 5, pp. 796-808. https://doi.org/10.1108/JHOM-04-2016-0057

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Publisher

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Emerald Group Publishing Limited

Copyright © 2016, Emerald Group Publishing Limited

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