Deliberative democracy has become the central reference point for democracy theorists over the last decade or so, influencing normative frameworks and the ways we conceptualize the workings of democratic societies. It has also been linked with a burst of experimentation with new procedures that involve citizens directly in deliberations about public policy.

But there is a contradiction at the heart of deliberative democracy: it seems that it cannot deliver legitimate agreements. Deliberative decisions are said to be legitimate when all those subject to them take part in free and equal debate, but in complex societies that can never happen. Few people can deliberate together at any one time, certainly not in any strict sense, so how can the results of a deliberative event be legitimate for non-participants? And why would people with passionately held views sit down and deliberate when there seems little advantage in them doing so?

This book explores these problems in theory and practice, searching for a solution that does not merely dismiss a strict understanding of deliberative democratic criteria. It reconsiders the theory of legitimacy and deliberative democracy, but goes further by examining cases of deliberation on health policy in the United Kingdom to see what problems emerge in practice, and how real political actors deal with them. The result is a complete rethink of the institutional limits and possibilities of deliberative democracy, one which abandons the search for perfection in any one institution, and looks instead to the concept of a multifaceted deliberative system.