title: Public involvement in health priority setting: future challenges for policy, research and society.
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.
authors.affiliation: Centre for Public Policy and Health, Durham University, Stockton on Tees, UK.
authors.forename: David James
authors.initials: DJ
authors.lastname: Hunter
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, London, UK.
authors.forename: Katharina
authors.initials: K
authors.lastname: Kieslich
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Littlejohns
authors.affiliation: RCN Research Institute, Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Sophie
authors.initials: S
authors.lastname: Staniszewska
authors.affiliation: Bioethics Centre, Department of General Practice & Rural Health, University of Otago, Dunedin, New Zealand.
authors.forename: Emma
authors.initials: E
authors.lastname: Tumilty
authors.affiliation: Department of Political Science, University College London, London, UK.
authors.forename: Albert
authors.initials: A
authors.lastname: Weale
authors.affiliation: Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK.
authors.forename: Iestyn
authors.initials: I
authors.lastname: Williams
mesh_terms: D003256:Community Participation; D006291:Health Policy / Q000639:trends*; D006292:Health Priorities; D012106:Research / Q000639:trends*
keywords: Authentic representation; Equitable health coverage; Legitimacy; Priority setting; Public participation