Education and debate p 318

A revolution is under way in health care. After decades of patriarchal provision of services governments are now accepting that patients should have a say in what is provided. Debates on priority setting have brought the case for public participation in difficult healthcare choices sharply into focus.1 Each new high profile drug launch or controversial therapy spurs further public discussion about what a national health service should provide and who should decide (p 273).2 At the level of individual patients there is a growth in demand for information,3 and a review published this week draws attention to the need to improve its quality (p 318).4 The launch of a new journal to promote debate about public participation in health care5 and the Council of Europe's recommendation that patients must be involved in defining quality of care underline that the movement is gaining momentum.

If services are to be shaped by patients' views, methodologically sound ways of …