Towards More Meaningful, Informed, and Effective Public Consultation

Changing Health Care in Canada, 2004

Provincial level recommendations focus on the development and implementation of policies that address the social influences on health, issues of representation of citizen involvement and processes that improve accessibility to involvement. The regional level recommendations consolidate those policies into an organizational structure entitled The Multi-Modal Continuum Model. Intrinsic to this model are collaborative health networks, which are comprised of formalized partnerships with organizations dealing with health, social services, community organizations, businesses, etc. Along with health professionals, social service and outreach workers, health planners and community partners, it is recommended that collaborative health networks employ community consultants whose sole aim is to identify concerns, needs and priorities from members of the community. These consultants will particularly focus on marginalized populations and will be hired based on their experiential knowledge of the targeted initiative. Salient to meaningful citizen participation is the need for training and education for all members of the collaborative health network. Resources will be required to develop training programs that focus on health issues, current health policies and programs, meeting procedures, health planning and evaluation, communication skills, group facilitation techniques, partnership building, conflict resolution, community building and research skills related to CP. The development of guides that focus on contacting the community, needs assessment mechanisms, priority setting and evaluation are also recommended.

2002

Australia and New Zealand Health Policy, 2008

Background: This paper examines work in deliberative approaches to community engagement used in Western Australia by the Department of Planning and Infrastructure and other planning and infrastructure agencies between 2001 and 2005, and considers whether the techniques could be applied to the development of health policy in Australia.

Public consultation has become a major part of planning in the last forty years and much has been written on the subject. This article reviews the writing generated over the past two decades and breaks it into sections respecting the theory and rationale behind consultation, the conceivable approaches to engage the public, and the means available to analyze and evaluate consultative efforts. Conclusions relevant to academics and practitioners are drawn as are suggestions from the authors concerning the principal gaps that needed to be filled in order for planners to have reliable tools to evaluate the effectiveness of consultative processes.

A common thread weaving through the current public participation debate is the need for new approaches that emphasize two-way interaction between decision makers and the public as well as deliberation among participants. Increasingly complex decision making processes require a more informed citizenry that has weighed the evidence on the issue, discussed and debated potential decision options and arrived at a mutually agreed upon decision or at least one by which all parties can abide. We explore the recent fascination with deliberative methods for public involvement first by examining their origins within democratic theory, and then by focusing on the experiences with deliberative methods within the health sector. In doing so, we answer the following questions ''What are deliberative methods and why have they become so popular? What are their potential contributions to the health sector?'' We use this critical review of the literature as the basis for developing general principles that can be used to guide the design and evaluation of public involvement processes for the health-care sector in particular. r

Health Policy, 2006

Deliberative processes are beginning to take effect in the public health sector. Public health organizations have a critical role in fostering local deliberation during the planning and implementation of community health efforts. The chief executive officer (CEO) of eight national public health constituent organizations were provided background readings about deliberation and its potential role in community public health planning. They were then interviewed about their prior knowledge of public health deliberation, impressions and thoughts about deliberation's role in public health, whether they could identify constituents using the approach, and the best method of disseminating information on deliberation. Information provided by stakeholders was analyzed to gauge the understanding and implementation of public deliberation. Four main themes emerged from the interviews including: general awareness and attitudes about public deliberation, barriers to deliberation, words of caution when using the deliberative approach, and dissemination of deliberation. Each of the CEOs interviewed favored deliberative approaches in public health planning that would ensure that the community's voice is present in the decision-making process. However, there are certain limitations to the approach that must be addressed before the full benefits of public engagement can be obtained in public health.

Leadership in Health Services, 2014

Purpose -The purpose of this paper is to describe and evaluate a novel approach to citizen engagement in health priority setting carried out in the context of Primary Care Trust (PCT) commissioning in the English National Health Service. Design/methodology/approach -Four deliberative events were held with 139 citizens taking part in total. Events design incorporated elements of the Twenty-first Century Town Meeting and the World Café, and involved specially-designed dice games. Evaluation surveys reporting quantitative and qualitative participant responses were combined with follow-up interviews with both PCT staff and members of the public. An evaluation framework based on previous literature was employed. Findings -The evaluation demonstrates high levels of enjoyment, learning and deliberative engagement. However, concerns were expressed over the leading nature of the voting questions and, in a small minority of responses, the simplified scenarios used in dice games. The engagement exercises also appeared to have minimal impact on subsequent Primary Care Trust resource allocation, confirming a wider concern about the influence of public participation on policy decision making. The public engagement activities had considerable educative and political benefits and overall the evaluation indicates that the specific deliberative tools developed for the exercise facilitated a high level of discussion. Originality/value -This paper helps to fill the gap in empirical evaluations of deliberative approaches to citizen involvement in health care priority setting. It reports on a novel approach and considers a range of implications for future research and practice. The study raises important questions over the role of public engagement in driving priority setting decision making.

Social science & medicine (1982), 2015

Deliberative methods are of increasing interest to public health researchers and policymakers. We systematically searched the peer-reviewed literature to identify public health and health policy research involving deliberative methods and report how deliberative methods have been used. We applied a taxonomy developed with reference to health policy and science and technology studies literatures to distinguish how deliberative methods engage different publics: citizens (ordinary people who are unfamiliar with the issues), consumers (those with relevant personal experience e.g. of illness) and advocates (those with technical expertise or partisan interests). We searched four databases for empirical studies in English published 1996-2013. This identified 78 articles reporting on 62 distinct events from the UK, USA, Canada, Australasia, Europe, Israel, Asia and Africa. Ten different types of deliberative techniques were used to represent and capture the interests and preferences of diff...

Research Square (Research Square), 2023

Background: The aim of this work is to characterize the processes associated with patient and public involvement (PPI) in the form of public consultations (PC) during the rst 10 years of operation of the National Committee for Health Technology Incorporation in the Uni ed Health System (Conitec) of Brazil and to identify factors associated with changes in Conitec's recommendations following these PC. Methods: This cross-sectional study analysed all processes related to the adoption of technology that took place in Brazil between 2012 and 2021 based on technical reports and self-reported information collected from PC participants. A multiple logistic regression model identi ed factors associated with changes in Conitec's recommendations following PC. Results: A total of 479 technical reports were published, of which 83% (n=400) were submitted to PC. Demands were made mainly by applicants from the state (n=262; 55%), regarding the adoption of medicines (n=367; 77%), in which context neoplasms and infectious diseases were the most frequent indications (n=66; 14% for each). A total of 264 (55%) processes resulted in a nal recommendation in favour of introducing the technology. Over the period of 10 years, 196,483 contributions were received in response to PC. The largest volume of contributions was made by patients and their families or representatives (n=99,082; 50.4%), females (122,895; 67%), white individuals (129,165; 70.8%) and individuals between the ages of 25 and 59 years (145,364; 79.9%). Alteration of the preliminary recommendation occurred in 13% (n=53) of the PC, with a higher proportion of recommendations being altered from 2017 onwards. Increased participation by patients had a signi cant impact on the alteration of the preliminary recommendation (Odds Ratio 3.87, 95% CI 1.33-13.35, p=0.02). Conclusions: It is necessary to develop PPI mechanisms that are more dialogical and less vulnerable to political contexts with the aim of establishing a more equitable and accountable health system.

Social Science & …, 2002

Agenda - A Journal of Policy Analysis and Reform, 2000

Ihere is a growing expectation among interest groups of all kinds that they will be consulted at relevant stages of public policy development. It is now X an accepted fact of Australian political life that organisations will consult their stakeholders at crucial stages in their key decision-making processes. There has also been a trend towards the institutionalisation of such arrangements. This trend has not been peculiar to Australia. When governments consider new forms of regulation, delegated legislation or public rule making, sophisticated consultative arrangements have become a dominant feature of the process. In this respect Australia has followed overseas trends. The Organisation for Economic Cooperation and Development (OECD) has noted that 'a strong trend towards renewal and expansion of public consultation in regulatory development' is under way in its member countries. The OECD has expressed strong approval of this trend and has championed it with the adoption and wide publication of a set of six propositions extolling the benefits of public consultation:

Healthcare Management Forum

This paper examines the impact of the emerging citizens’ assembly model of public engagement on health system planning and management. The characteristics that distinguish this model from more traditional approaches such as surveys and town hall meetings are elaborated using the case study of the recent Citizens’ Regional Health Assembly. The paper concludes by suggesting the possibility of a new type of relationship between health system decision-makers, providers and the community.

Health Economics, Policy and Law, 2006

Despite its obvious appeal, the concept of public involvement is poorly defined and its rationale and objectives are rarely specified when applied to current health policy contexts. This paper explores some of the underlying concepts, definitions, and issues underpinning public involvement policies and proposes a set of criteria and questions that need to be addressed to allow for the evaluation of public involvement strategies and their impact on the health policy process. It aims to further our understanding of the role that public involvement may play in contributing to health systems that are responsive to the needs and priorities of the public, and, ultimately, providing better health and health care services to the community at large.

Health Policy, 2005

How best to involve the public in local health policy development and decision-making is an ongoing challenge for health systems. In the current literature on this topic, there is discussion of the lack of rigorous evaluations upon which to draw generalizable conclusions about what public participation methods work best and for what kinds of outcomes. We believe that for evaluation research on public participation to build generalizable claims, some consistency in theoretical framework is needed. A major objective of the research reported on here was to develop such a theoretical framework for understanding public participation in the context of regionalized health governance. The overall research design followed the grounded theory tradition, and included five case studies of public participation initiatives in an urban regional health authority in Canada, as well as a postal survey of community organizations. This particular article describes the theoretical framework developed, with an emphasis on explaining the following major components of the framework: public participation initiatives as a process; policy making processes with a health region; social context as symbolic and political institutions; policy communities; and health of the population as the ultimate outcome of public participation.