[Local and citizen participation and representation strategies in Healthcare Administration]. / Las estrategias de participación y representatividad local y ciudadana en la Administración Sanitaria.

The public as a whole are the rightful owners and beneficiaries of the public healthcare system in our country. As such, they collaborate in its maintenance and upkeep through payment of taxes. The government is accountable to the public as to how the ever-scarce resources are allocated. When it comes to the area of healthcare, this represents an added factor of complexity and specificity which makes the issue a particularly sensitive one. In the field of healthcare, both the General Health Law and the Law of Catalan Healthcare Code define the actors responsible for the public representation of its citizens. Nevertheless, their inclusion does not necessarily guarantee the perception of participation by its citizens or that of a greater democratic quality. The model must be understood as the intermediary link between a legally regulated framework and the actual debate, which in a globalized world with such an immense volume of information available to citizens and with the current online social networking sites, occurs at the heart of society in general, even though government has no such incorporation channel. The system will need to be developed as new technologies enable this, towards a more direct and more global models for participation. Participation is a flexible concept which, as far as possible, needs to adapt to the different problems as well as the different regions. Legislative regulation must therefore provide the mechanisms and stable frameworks for participation. In turn however, it must also establish dynamic systems capable of adapting to and incorporating the varying demands and methods of participation coming from the public in response to disparate processes.

Las estrategias de participación y representatividad local y ciudadana en la Administración Sanitaria / Local and citizen participation and representation strategies in Healthcare Administration

Los ciudadanos son los propietarios y beneficiarios del sistema sanitario público de nuestro país. Como tales colaboran en su mantenimiento a través de los impuestos. Los gobernantes tienen la obligación de rendir cuentas a la ciudadanía de cómo se utilizan los recursos, siempre escasos y que, en materia de sanidad, tienen un suplemento de complejidad y especificidad que los hacen especialmente sensibles. En el ámbito de la salud, tanto la Ley General de Sanidad como la Ley de Ordenación Sanitaria de Cataluña determinan los actores en los que recae la representación de los ciudadanos. Sin embargo, su incorporación no necesariamente garantiza la percepción de participación por parte de la ciudadanía ni una mayor calidad democrática. El modelo debe entenderse como el eslabón intermedio entre un marco regulado legalmente y el debate real que, en un mundo globalizado con gran volumen de información a disposición del ciudadano y con las actuales redes sociales electrónicas, se produce en el seno de la población, aunque no exista un cauce de incorporación por parte de la administración. Será necesario evolucionar el sistema, a medida que las nuevas tecnologías lo permitan, hacia formas de participación más directas y más globales. La participación es un concepto líquido que, en la medida de lo posible, es necesario adaptar, tanto a las diferentes problemáticas como a los distintos ámbitos territoriales. La regulación legislativa debe proveer de mecanismos y marcos estables de participación; pero, a su vez, ha de prever mecanismos ágiles que permitan adaptarse e incorporar las distintas demandas y formas de participación emanadas de la ciudadanía ante procesos dispares (AU)

The public as a whole are the rightful owners and beneficiaries of the public healthcare system in our country. As such, they collaborate in its maintenance and upkeep through payment of taxes. The government is accountable to the public as to how the ever-scarce resources are allocated. When it comes to the area of healthcare, this represents an added factor of complexity and specificity which makes the issue a particularly sensitive one. In the field of healthcare, both the General Health Law and the Law of Catalan Healthcare Code define the actors responsible for the public representation of its citizens. Nevertheless, their inclusion does not necessarily guarantee the perception of participation by its citizens or that of a greater democratic quality. The model must be understood as the intermediary link between a legally regulated framework and the actual debate, which in a globalized world with such an immense volume of information available to citizens and with the current online social networking sites, occurs at the heart of society in general, even though government has no such incorporation channel. The system will need to be developed as new technologies enable this, towards a more direct and more global models for participation. Participation is a flexible concept which, as far as possible, needs to adapt to the different problems as well as the different regions. Legislative regulation must therefore provide the mechanisms and stable frameworks for participation. In turn however, it must also establish dynamic systems capable of adapting to and incorporating the varying demands and methods of participation coming from the public in response to disparate processes (AU)