Obtaining public input for health‐systems decision‐making: Past experiences and future prospects

Abstract: Interest in finding more effective methods for public involvement in decision‐making about health systems is more widespread than ever in Canada since significant aspects of health‐care decision‐making were devolved from provincial governments to regional health authorities. Involving the public can be risky business, however, as the accountability and legitimacy of decisions made by governing authorities are often assessed against the nature and degree of interaction that occurs with the public. Consequently, decision‐makers in a variety of policy domains routinely struggle with questions about when it is appropriate to involve the public, what the most effective means are for doing this, and how to measure their success. The authors analysed these issues by documenting the experiences of health‐systems decision‐makers in two Canadian provinces (Ontario and Quebec) with public consultation and participation over the past decade. Their findings illustrate that despite the different roles and responsibilities held by Ontario and Quebec decision‐makers, decisions to consult with their communities are driven by the same basic set of objectives: to obtain information from and to provide information to the community; to ensure fair, transparent and legitimate decision‐making processes; and to garner support for their outcomes. Decision‐makers also acknowledged the need to rethink approaches for involving the public in decision‐making processes in response to the perceived failure of past public participation and consultation processes. While these experiences have clearly left some participation practitioners feeling beleaguered, many are approaching future community consultation processes optimistically with plans for more focused, purposeful consultations that have clear objectives and more formal evaluation tinged with a healthy dose of pragmatism. Sommaire: L'intérêt que I'on porte à trouver des méthodes plus efficaces pour inciter le public à participer à la prise de décisions au sujet des systèmes de santé ne cesse de grandir au Canada depuis que les gouvemements provinciaux ont transféré aux autorités régionales la responsabilité d'importants aspects de la prise de décisions dans ce domaine. Cependant, faire intervenir le public peut être une affaire délicate, car la transparence et la légitimité des décisions prises par les autorités existantes sont souvent évaluées par rapport à la nature et au degré d'interaction qui se produit avec le public. C'est pourquoi, les décideurs dans divers domaines de politiques ont généralement de la difficultéà déterminer quand il convient de demander I'avis du public, quels sont les moyens les plus efficaces pour le faire et comment mesurer leur succès. Nous avons analysé ces questions en documentant les expériences que les décideurs des systèmes de santé de deux provinces canadiennes (l'Ontario et le Québec) avaient eues en ce qui concerne les efforts de participation et de consultation publique au cours de la derniére décennie. Nos conclusions démontrent qu'en dépit des divers rôles tenus et diverses responsabilités assumées par les décideurs de I'Ontario et du Québec, leur déision de consulter leurs communautés est guidée par les mêmes principaux objectifs: obtenir de I'information de la communauté et lui en foumir; assurer des processus de prise de déisions justes, transparents et légitimes et obtenir I'aval de leur décision. Les décideurs ont également reconnu le besoin de repenser les approches visant à faire participer le public aux processus de prise de décisions suite à I'échec perçu des expériences antérieures de participation et de consultation du public. Alors que certains partisans de la participation ont été clairement découragés par ces expériences, un grand nombre envisagent avec optimisme les processus de consultation communautaire. Ils croient que les consultations pourraient être plus focalisées et plus déterminées visant des objectifs clairs et une évaluation plus formelle et empreinte d'une bonne dose de pragmatisme.     

Rethinking the marketing of World Heritage Sites: Giving the past a sustainable future

Despite significant global prestige and a strong brand presence, UNESCO World Heritage Sites remain underfunded with many unable to self-sustain. Increasing government budget constraints have further restricted funds and UNESCO's “World Heritage Fund”—UNESCO's sole source of financial assistance available to sites—has fallen to approximately $3M USD per annum. Few sites are able to fully offset these budget constraints through tourist revenue alone, and those able to do so often require additional repairs due to damage from visitors exceeding the site's capacity. Although this situation is widely acknowledged within the heritage literature, few papers have proposed long-term strategic solutions beyond marketing and management plans for individual sites. The authors address this pressing issue by questioning whether World Heritage Sites in general are currently being marketed in an optimized manner and proposing a new framework for creating stronger and more appropriate relationships between visitors and sites using Berthon et al.'s the Aesthetics and Ontology model. The authors argue that clarifying and optimizing the marketing of World Heritage through this lens with its focus on the consumption experience of visitors and other stakeholders will yield positive results for both the management of the sites and for their impact on surrounding communities. Furthermore, the authors recommend that policies surrounding the management of these valuable resources and sources of tourist revenue be modified to reflect these findings.     

Building metropolitan governance capacity: The case of the Communauté métropolitaine de Montréal

Abstract: This article is about building metropolitan governance capacity. Based on the case study of the Communauté métropolitaine de Montréal (the Montreal Metropolitan Community), the authors seek to understand how this new metropolitan institution develops its capacity to manage metropolitan issues. What factors influence metropolitan governance capacity? What are the impacts of actor behaviour, incentive structures, and political leadership on that capacity? Specifically, results focus on two of the CMM's areas of responsibility: land‐use planning, and social and affordable housing. Based on the analysis of official documents of the CMM (its act of incorporation, activity reports, budget, etc.) and thirteen interviews with elected municipal officials and public servants, the authors show that the building of metropolitan governance capacity is influenced by the interactions between those three factors, as well as by other elements specific to each context.     

Credibility,source identification and message acceptance: The case of political persuasion

Abstract

This paper addresses questions related to effects of source credibility on message acceptance. More specifically, we look at (a) the effects of attributed credibility of the source on message acceptance in situation of source identification versus non‐identification, and (b) the effects of attributed credibility of two competitive sources on the acceptance of their respective messages in positively versus negatively predisposed audiences.

Source identification and source competition relate to the more general problem of persuasion and inoculation. Political parties often strive to persuade partisan, hostile, or politically neutral audiences while simultaneously trying to inoculate them against the message of opposing parties. These processes of persuasion can take place in situations where the source is either identified (e.g., a well‐known politician clearly linked with a political party) or not identified (e.g., a journalist who presents a politician's point of view without naming him/her). In cases where the source has been identified, the audience may remember the message itself and yet forget who had advanced the message. This raises the question of the extent to which communicators should concern themselves with the attributed credibility of the source in situations of either source identification or non‐identification? And how important is credibility in reinforcing the support of partisans or in persuading neutral and hostile audiences? These are some of the issues we examine experimentally in this article.     

Technicity and the Power of Institution

Law and Critique - Our question is whether technicality can institute, and thus create a new power, or even legitimize and maintain institutions. It claims to do so, all haloed by sacredness or...     

新疆的事实终将拆穿西方的谎言

2021年9月,我应中国经济联络中心邀请,作为在华外国工商界代表团的一员访问了新疆。这是我第一次访问新疆。启程之前,我的内心充满好奇和疑问,因为以前对新疆的了解大多来自西方媒体“强迫劳动”“种族灭绝”等连篇累牍的报道。但当我踏上新疆土地的时候,目光所及是干净整洁的街道、拔地而起的高楼、熙熙攘攘的商铺和洋溢在人们脸上幸福的笑容。耳听为虚,眼见为实。我为新疆的繁荣稳定感到高兴,也对西方政客和媒体肆意编造谎言抹黑污蔑新疆的行径感到气愤!