Education And Debate

Setting priorities: is there a role for citizens' juries?

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7046.1591 (Published 22 June 1996) Cite this as: BMJ 1996;312:1591
  1. Jo Lenaghan, health policy researchera,
  2. Bill New, senior research officerb,
  3. Elizabeth Mitchell, communications officerc
  1. a Institute for Public Policy Research, London WC2E 7RA
  2. b King's Fund Policy Institute, London WIM 0AN
  3. c Cambridge and Huntingdon Health Authority, Fulborn Hospital, Cambridge CB1 5EF

    Citizens' juries are an attempt to meaningfully involve members of the public in decisions which affect them in their own communities. The Institute for Public Policy Research and Cambridge and Huntingdon Health Authority have recently piloted the first jury in the United Kingdom. Sixteen jurors sat for four days, hearing evidence from a number of expert witnesses. The jurors were asked to consider how priorities for health care should be set, according to what criteria, and to what extent the public should be involved in this process. This pilot was also an attempt to assess the process itself, and our initial evaluation indicates that, given enough time and information, the public is willing and able to contribute to the debate about priority setting in health care.

    One sixth of health authorities are now explicitly excluding certain treatments from public provision.1 Who is making these decisions, and according to what criteria? What opportunities do the public have to challenge or be involved in these decisions? As Anne Bowling has pointed out, obtaining a representative view from the public can be difficult, and the methodology of ranking lists of treatments and services can be criticised as superficial in relation to the complexity of the decision to be made.2 The Institute for Public Policy Research in partnership with Cambridge and Huntingdon Health Authority has recently piloted the first citizens' jury in the United Kingdom in an attempt to develop a more sophisticated technique for involving the public in these difficult decisions.3

    Methods

    Professional recruiters (Opinion Leader Research) were given a demographic breakdown of the Cambridge and Huntingdon area, and 16 people were selected by stratified random sampling to represent their community. The jury sat for four days, and during this time the members were presented with information to help them to …

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