The handling of the junior doctors’ strike reinforces a vision of the NHS where key voices are neither sought nor listened to

Despite the rise of patient and public involvement, evidence from the junior doctor’s strike suggests that little has changed in terms of the power of Westminster and the lack of public accountability for decisions that lie at the heart of how the NHS is organised. Here, Jonathan Tritter and Mio Fredriksson discuss the tensions between representative and participatory democracy in NHS decision-making, and argue that Jeremy Hunt is pursuing a centralised vision of the NHS rather than responding to consumer-driven demand.