The interactions between individuals and institutions become more complicated for many reasons: pressure for subjective recognition grows; polical sites where people can debate on health care issues and on the the values about clinical services are diminishing. In this sense, it is important to plan health care pathways developed with the collaboration between doctors and patients. Therefore citizens’ participation could be considered a way in order to re-think collectively the main structures of the local welfare.
Keywords: Local welfare, the citizens’ participation, innovation of the social services, participatory tools, creative negotiation.