ABSTRACT
Recent health service reforms in Western countries emphasise public and patient involvement (Vallgårda et al. 2001; Vos 2002). The increasing participation of users in decisions around treatment, service development and evaluation has been central to this process. The consequences are becoming clear as relationships between the state and citizens and between the public, patients and organisations within the healthcare system are redrawn. This shift in health policy has generated significant debate between policy makers, within government and the media.
