Governance and public involvement in the British National Health Service: understanding difficulties and developments.

The article considers the role of public involvement in the British National Health Service in the context of the wider shift from government to governance. Based on a comparative case study, it identifies different outcomes from a single policy initiative in two localities. It argues, following Jessop, that accounts of governance which rest on inter-organisational relationships are inadequate, and that we also need to look at inter-systemic and inter-personal levels for more complete explanations. Investigating the relationships between these levels, we derive an account of governance within which to situate the role of public involvement. It is against this background that we focus on why the methods of involvement deserve greater attention for their substantive contribution to its quality and effectiveness.