This chapter analyses the origins of user participation in the public services, specifically, the provision of health and personal social care. It demonstrates that participation by public service users in the policy process is not a recent concept and has traced the origins of public participation from the 1960s when it gained in prominence. Contemporary welfare provision advocates an active role for service users regarding their care in addition to the provision of services being more responsive to those who seek to use them. In terms of social policy issues, more specifically, Richardson believes that people participate when they engage in activities relating to the provision of social services by central or local government. In terms of service provision, the increasing size, bureaucracy and therefore remoteness of the welfare state and the increasingly complex and varied needs of service users can be identified as major factors in encouraging moves to enhance user participation.