Health care reform strategies proposed by provincial governments include decentralized funding and increased public participation in decision making. These proposals do not give details as to the public participation process, and a number of questions have been raised by the experience of some communities. Which citizens should form the decision-making group? What information do they need? What kinds of decisions should they make? What level of participation should they have? The results of a survey by Abelson and associates (see pages 403 to 412 of this issue) challenge the assumption that "communities" are willing to participate in health-care and social-service decision making. Willingness varied according to the composition of the groups polled, and participants' support for traditional decision makers increased after the complexities of the decision-making process were discussed. However, whereas their study measured willingness to participate at one point in time only, experience gained from Ontario's Better Beginnings, Better Futures project indicates that, given sufficient time, "ordinary" citizens are willing and can acquire the skills needed to decide how resources should be allocated for social services.
Notes
Cites: Can J Commun Ment Health. 1994 Fall;13(2):213-2710151077
Cites: Can J Commun Ment Health. 1994 Fall;13(2):229-4010151078
Cites: BMJ. 1993 Aug 7;307(6900):373-78374424
Cites: Soc Sci Med. 1993 Oct;37(7):851-78211302
Cites: Int J Health Serv. 1994;24(2):201-298034390
Cites: BMJ. 1993 Aug 14;307(6901):435-88374459
Cites: Lancet. 1991 Apr 13;337(8746):891-41672977
Cites: Can J Commun Ment Health. 1994 Fall;13(2):197-21110151076
Comment On: CMAJ. 1995 Aug 15;153(4):403-127634217