Participatory democracy and development of a public health policy?

Abstract

In view of controversies around breast cancer screening, the Ministry of Health asked the French National Cancer Institute to organize this consultation to clarify the benefits and limitations of breast cancer screening, health objectives, organizing and tackling the health inequalities of this program. It has combined the setting up of an independent and multidisciplinary steering committee, a conference of citizens and professionals. It relied on the hearing of experts representing the trends of the controversy, on a technical and prospective report and on the analysis of nearly 500online contributions. At the end of this process, the policy committee produced a report. In the end, two scenarios were presented, leading to a complete overhaul of the current screening process. As a result of this report, the Ministry announced the action plan for the renovation of organized breast cancer screening in 12measures in April2017. The discussion focuses on the consultation methodology as a tool for health democracy and on the levels of arbitration that led to the action plan. The objective is to reflect on the possible interactions between consultation and decision-making and to propose benchmarks for the development and improvement of this consultation.