Paradigm shift towards co-production in the European healthcare?A literature review

Public service delivery has never been the area of a state monopoly, but the process of the “destatization” of public service delivery accelerated with the wave of new public management (NPM). The competition between private suppliers of public services was expected to reduce public expenditures and improve the quality of services. However, current scepticism towards NPM triggered the revival of the idea of co-production, i.e. direct participation of citizens in public service delivery. This paper reviews the practices of co-production in European health care systems. It is based on an extensive definition of co-production, not only including co-delivery, but also co-planning, co-financing and co- -evaluation. The existing evidence regarding the effects of co-production is also reviewed.