COMMUNITY PARTICIPATION IN HEALTH-CARE DECISION-MAKING - IS IT FEASIBLE

Health care reform strategies proposed by provincial governments inclu de decentralized funding and increased public participation in decisio n making. These proposals do not give details as to the public partici pation process; and a number of questions have been raised by the expe rience of some communities. Which citizens should form the decision-ma king group? What information do they need? What kinds of decisions sho uld they make? What level of participation should they have? The resul ts of a survey by Abelson and associates (see pages 403 and 412 of thi s issue) challenge the assumption that ''communities'' are willing to participate in health-care and social-service decision making. Willing ness varied according to the composition of the groups polled, and par ticipants' support for traditional decision makers increased after the complexities of the decision-making process were discussed. However, whereas their study measured willingness to participate at one point i n time only, experience gained from Ontario's Better Beginnings, Bette r Futures project indicates that, given sufficient time, ''ordinary'' citizens are willing and can acquire the skills needed to decide how r esources should be allocated for social services.