Public Participation in NHS Construction Projects

This PhD thesis explores public participation in NHS construction projects. Despite the prominence of public participation in both built environment projects and NHS activities there has been little attention on the role of public participation specifically in NHS construction projects, and which actors are engaged in those activities. The aim of the study is therefore to understand the rationales, practices and impacts of public participation on NHS construction projects. The study has been approached through multiple, exploratory case studies that compare public participation in five NHS construction projects. The case study projects range from the construction of a small health centre, to mixed developments with health and community services and housing. The case studies are positioned within a framework based on the rationale behind, and the actual practices of, public participation. The actors’ rationale for public participation is placed along a continuum between ‘consumerist’ (public participation as a means to an end) and ‘democratic’ (public participation as an end in itself). The practice and effects of public participation are placed along a continuum which runs between ‘rhetoric’ (no transfer of public participation claims into practice) and ‘substantive’ (public participation impacts the project). The analysis argues that there is a lack of evidence to show any significant impact of public participation on these projects, or that confirms the claimed benefits associated with conducting public participation. Indeed, much public participation can be seen as oriented to legitimising already taken decisions. Also, much public participation is conducted by and through intermediary or ‘secondary actors’ such as NHS agents and consultants or specific community groups rather than ‘the NHS’ or ‘the public’. Finally, public participation is often politically motivated, with local councillors and MPs using specific issues in these construction projects as a broader political platform.