[Patient and public involvement in health care--a comparison between recent english and german policies].
OBJECTIVE
Involving patients and citizens in health care and policy has become a regular part of health care reform programmes in highly developed societies. Systematic knowledge about particular initiatives and their implementation is mostly lacking as are comparative approaches. In this article recent attempts to promote patient and public involvement in England and Germany are analysed based on available evidence. These two countries represent different types of health care systems and their governance but share a similar history of paternalistic styles of health policy making and health care provision.


RESULTS
This study shows various recent policy-initiatives in both countries. In total, English policies cover a broader spectrum and are better institutionalized. This applies especially in the field of patient information, patient surveys and for collective participation on various policy levels. The most remarkable German policies can be found in the fields of patient advice and support of self-help groups. Recently institutionalized mechanisms of collective involvement have to be considered as initial steps; preliminary experience shows the need for further development.


CONCLUSIONS
Experiences in both countries demonstrate that a profound cultural change towards more patient and public involvement in health will have to be realised with a long-term perspective and will have to learn from ongoing practice. Sufficient support, adequate information and transparency will be essential to get and keep the lay public involved.
Forster
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R
Institut für Soziologie Universität Wien, Wien, Austria. rudolf.forster@univie.ac.at
Kranich
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C
D003256:Community Participation / Q000379:methods*; D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration*; D004739:England; D005858:Germany; D006291:Health Policy; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration*; D010358:Patient Participation / Q000379:methods*; D011640:Public Policy