Participatory Governance and Healthcare. Opportunities and Perils

Since the 1990s, public policy has made incremental transformations towards greater involvement of common citizens in policymaking. The vast body of literature on healthcare service co-production and patient empowerment testifies to the persistent relevance of participatory ideas and practices in the healthcare debate. This chapter analyzes participation through the lens of an interpretative approach to public policy. It discusses the macro, meso and micro connections between participation and the evolution of contemporary democracies. Secondly, it explores the dilemmas and unintended consequences that result from using participation as the ultimate justification for policy interventions. Finally, it highlights the potential depoliticizing effect of participatory procedures on decisions about collective problems and social goals.