Advocacy and information acquisition: Why non-governmental organizations participate in local health policy in England

Background. Non-governmental organizations (NGOs) are often regarded as a means of ‘democratizing' health policy processes. Health policy-making is to some extent devolved to local health administrators and professionals in England who are in turn, legally mandated to involve local communities – including NGOs – in their decision-making. This paper reports findings from doctoral research that investigated NGOs' perceptions and experiences of participating in local health policy in England, focusing on their reasons for participating. Methods. This paper draws on an ethnographic case study of one local health policy field in England that used documentary data (e.g. meeting minutes); semi-structured interviews with representatives of 33 NGOs and 11 local health policy makers; and observations of meetings where health policy was discussed. Interview data were analyzed using thematic content analysis and corroborated, supplemented and tested with observation and documentary data. Results. NGOs had multiple, simultaneous reasons for participating in local health policy. They were motivated by their belief that they had a duty to represent patients' and carers' experiences in order to highlight their needs and improve health services. They also participated to gather intelligence about policy ideas, build networks and discover funding or project development opportunities. Discussion. NGOs were not always motivated to contribute to health policy when they participated. Whilst they may enhance the diversity of interests in local health policy by acting in the interests of patients and carers, NGOs also participate for their own, organizational interests.