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Education And Debate

Consulting the public about health service priorities

BMJ 1995; 311 doi: (Published 28 October 1995) Cite this as: BMJ 1995;311:1155
  1. Cameron Bowie, former director of public healtha,
  2. Ann Richardson, project directorb,
  3. Wendy Sykes, research consultantc
  1. aDepartment of Public Health, Somerset Health Authority, Taunton TA2 7PQ
  2. bLondon NW3 4DA
  3. cLondon N10 3EP
  1. Correspondence to: Dr Bowie, The Old Farmhouse, Clayhanger, Chard, Somerset TA20 3BD.
  • Accepted 27 August 1995

Consulting the public is an important component of commissioning health services. Somerset Health Authority has devised a method of consultation using eight focus groups meeting three times a year. Each group consists of 12 people, and together the groups are demographically representative of Somerset's population. The groups are asked about issues that are concerning the health authority, and their views have influenced health authority decisions. Each group is given some background information before the meeting, together with more information at the meeting. The discussions are tape recorded and analysed for qualitative information, but the groups are also asked to score certain priorities. The groups have been found to be representative, valid, and focused on community rather than individual values. Health authorities wanting to know the values people attach to health services should adopt this qualitative approach to consultation.

Few health authorities know what values their public holds about health priorities. Under the impetus of the Oregon exercise (in which the public helped to decide what services would be provided with public funds1) and with express government encouragement2 a number of authorities have sought the views of their populations on various topics.3 4 Often such consultation has used the public as consumers to comment on how specific services should be changed. When it has focused on broader issues the questions have tended to be hypothetical and the results difficult to interpret.5

Yet investment decisions about health service priorities are being made by health authorities without knowledge of what the people for whom they are making these decisions are thinking. While some decisions can be made on technical grounds or derive from government directives, others are based on value judgments. It is these that Somerset Health Authority has sought to elicit from its public. A research project was …

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