• patient views
• public opinion
• National Health Service

At the heart of the issue of lay involvement in the British NHS lies a contradiction—the enthusiastic rhetoric advocating it at all levels is not matched by significant and meaningful user involvement in practice. Since increased participation of patients and the public in health care is recognised internationally to be desirable, an examination of the implementation of the policy in the NHS will be of benefit to policy makers, managers, and clinicians struggling with this issue more widely.

Publications such as “The new NHS: modern, dependable”¹ produced shortly after the Labour government came to power in the UK and subsequent policy statements such as “The NHS Plan”² certainly demonstrate a rhetorical commitment to lay involvement backed up by the introduction of particular models, including the patient advocacy service and patients’ …