Summary:

Drawing on debates about the nature and significance of quasi-autonomous government organizations, this article asks what happens when trends towards agency creation by government and trends towards stakeholder participation in policy processes come together. Issues are considered through an examination of the National Institute for Clinical Excellence, one of a series of new regulatory bodies set up in Britain after 1997 and given the task of providing national guidance on treatments and care for people using the health service. The analysis points to the emergence of a new form – the dialogic intermediary organization. Such an organization, while maintaining close and informal links with government, attempts to build legitimacy for its activities through multiple and potentially competing engagements with diversely constituted publics. The potential theoretical and political importance of dialogic intermediary organizations, and some implications for their fuller empirical study are briefly explored.