The last 20 years have seen increasing interest in the use of Delphi in a wide range of health-care applications. However, this use has been accompanied by attempts to codify and define a "true Delphi". Many authors take a narrow view of the purpose of Delphi and/or advocate a single prescriptive approach to the conduct of a Delphi study. However, as early as 1975, Linstone and Turoff pointed to the danger of attempting to define Delphi as one would immediately encounter a study that violated that definition. Through critical examination of some of the controversies and misunderstandings that surround Delphi, this paper aims to dispel some of the myths and demonstrates the wide scope and potential of this versatile approach.

There is increasing interest, in the UK and elsewhere, in involving the public in health care priority setting. At the same time, however, there is evidence of lack of clarity about the objectives of some priority setting projects and also about the role of public involvement. Further, some projects display an apparent ignorance of both long-standing theoretical literature and practical experience of methodologies for eliciting values in health care and related fields. After a brief examination of the context of health care priority setting and public involvement, this paper describes a range of different approaches to eliciting values. These approaches are critically examined on a number of dimensions including the type of choice allowed to respondents and the implications of aggregation of values across individuals. Factors which affect the appropriateness of the different techniques to specific applications are discussed. A check-list of questions to be asked when selecting techniques is presented.

Explicit priority setting in healthcare, which often involves multiple criteria and value judgements, has come to prominence in a number of different healthcare systems over the past decade. Drawing on the results of a survey of priority setting in practice in the UK National Health Service, this paper analyses issues associated with quantification in priority setting, focusing on techniques for eliciting and aggregating values, the criteria and form of models used and their application in priority setting. The findings reveal a clear focus on equity, a strong concern to demonstrate openness, consistency and transparency in priority setting-leading to greater use of explicit multi-criteria models-and a notable focus on the quality of 'evidence'. However, reported difficulties in weighting over-long lists of non-commensurate and overlapping criteria, the inclusion of inappropriate criteria, and attributes of the form of models employed, lead to the conclusion that the implications of the methods are not always appreciated, the resulting priority 'scores' sometimes misunderstood and, in some cases, the concern for transparency and explicitness appears to outweigh concern for methodological understanding-leading to an illusion of transparency.

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Waiting lists for hospital inpatient treatment have existed since the foundation of the NHS. There have been many theories put forward to explain them and a wide range of proposals have been advanced to reduce or eliminate them. The effect of the recent changes in the NHS, coupled with the renewed political focus on waiting lists, is explored. It is concluded that access to waiting lists may be restricted, either by explicit rationing or as a result of contractual specifications. Further, the introduction of GP Fundholding, together with the purchaser-provider split, could result in a two-tier service, at least for non-urgent patients. These conclusions are illustrated by the findings from a simple simulation model.