This paper analyses the processes of politicisation of health care, notably the role of civic engagement and involvement of patients in these processes. We argue that civic engagement has a multifaceted nature and is either enhanced by top-down initiatives-fostered by public policies and private interests- or expressed through bottom-up civic participation.
Patients and citizens have participated in public hearings and consultations, advisory bodies and they formed national and transnational associations and coalitions. Furthermore, they have been involved in formal advocacy, lobbying initiatives, spontaneous mobilizations, online consultancy forums or, even, in an experience-based production of evidence.
By analysing these processes, it is argued that health care is not only politicised but due to the multifaceted nature of civic engagement also de-politicised and re-politicised. The emergence of these intertwined processes is based on the analysis of civic engagement of patients and carers during two recent politicised debates in the Czech Republic surrounding the topics of vaccination and mental health care reform.
The analysis is based on the qualitative study carried out both online and offline in the Czech Republic as part of the project "Civic engagement and the politics of health care." More specifically, an analysis of primary and secondary documents is complemented with observations and semi-structured interviews with patients, citizens and policy-makers.