Abstract

Public participation in the policy process is being encouraged, is happening more frequently and is more valued. Nowhere is this trend more apparent than in the area of health care. Canadians are becoming more involved in the health care decision-making process. They are taking a more active role in decisions that affect their health and health services that are provided for them. Citizens have been invited by their provincial and federal governments to take part in the health policy process at many decision levels. They have been offered a seat at the decision-making table. This invitation raises an important issue. Is the public really permitted to take all the room that governments claim they are making available at the decision-making table? This thesis reviews the history of public participation in health care policy leading up to the adoption of the National Medical Care Insurance Act (Medicare) in 1968 to the present. It examines participation by citizens as individuals and as members of groups. Public involvement at the regional, provincial and federal levels is reviewed. This thesis identifies the variables, which impact on public participation. It examines and analyzes whether the public is able to participate in developing and implementing health policy in a valued and meaningful way. It demonstrates why public participation in health care decision-making is more successful in some situations than in others.