(Effect of discussion and deliberation on the public's views of priority setting in health care: focus group study)
Public participation in healthcare rationing decisions may be of limited value if people are not allowed time to reflect on their opinions, say researchers in this week's BMJ. It is NHS policy that the views of the public should play a greater role in setting healthcare priorities and the most common (and cheapest) approach of determining the public view has been by means of a straightforward questionnaire. However, Dr Paul Dolan and colleagues from the University of York find that once someone has had the opportunity to discuss an issue in a group format, their feelings may be quite different, thus rendering the opinions expressed in a questionnaire unreliable.
In their study the authors found that initially over half of the 60 people surveyed wanted to give lower priority to smokers, heavy drinkers and illegal drug users, yet after reflection and discussion many people no longer favoured this discrimination. Dolan et al say that when people discuss the complex issues involved in priority setting, they realise that things may not be as straightforward as they had imagined. It also makes them more sympathetic towards the role that managers play in the rationing of healthcare services, say the authors.
They conclude that if patients' considered opinions are to be included in the priority setting process, it should be noted that the value of surveys that do not allow the time or opportunity for reflection may be in doubt.
Contact:
Dr P Dolan, Senior Lecturer in Health Economics, Sheffield Health Economics Group, University of Sheffield P.Dolan@sheffield.ac.uk