Tea, biscuits, and health care prioritizing.

I t i s m id -afternoon in december in a community meeting room in Wolverhampton, a small city in England’s Midlands. It is damp and the wind is up, and it is nice to learn that afternoon tea will be served prior to conducting business. Daphne Austin, a public health physician from a local service agency, sets about serving tea and biscuits to nine people who have been recruited to discuss their views about National Health Service (NHS) coverage of an expensive new therapy. Since 1991, British government policy has mandated public involvement in health services decisions. Using a range of techniques for informed public involvement— polling, focus groups, and citizen juries in community and academic settings—the country has been developing methods for holding conversations with the public and feeding them back to the health care system. All of these techniques rely on deliberation—giving the public the tools and time to consider the pros and cons of various issues. The people assembled today are middle-aged and older—three women and six men, all white but one. They are a convenience sample drawn