BACKGROUND: Users of the Norwegian health services have a legal right to influence the services through user committees, and also to assess the treatment they are being subject to on an individual basis. The aim of this study was to investigate the experience health personnel have with patient participation in hospital wards. MATERIAL AND METHODS: Qualitative interview study with 18 health workers from 12 hospital wards in Central Norway Regional Health Authority. RESULTS: Health personnel stated that they took the initiative to patient participation in the hospital ward. User representatives were either appointed by the user committee or chosen because of personal characteristics that suited the ward's needs. Health personnel were positively surprised by the user representatives' qualifications. It was still a challenge to achieve equality between health personnel and user representatives. Health personnel limited patient participation, especially regarding medical issues. INTERPRETATION: Patient participation in hospital wards seems to be regulated by health personnel, who initiate and limit such participation.