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.
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.
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.
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.
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.
Hunter, D.J., 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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