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.     

Kids,guns, and killing fields

He has written widely on problems of firearms and gun control, including two books. His is currently researching the effect of poverty on the urban underclass, alcohol and drug treatment programs for the homeless, and health and other social problems of street children in Latin America.     

Reviews

Lyndall Ryan (ed.), ‘Secret Women's Business: The Hindmarsh Island Affair’, Special issue of Journal of Australian Studies (University of Queensland Press) Brisbane, no. 48, May 1996.

Gisela Kaplan, The Meagre Harvest: The Australian Women's Movement 1950s～1990s (Allen & Unwin) St Leonards, 1996.

R. Emerson Dobash, Russell P. Dobash and Lesley Noaks (eds), Gender and Crime (University of Wales Press) Cardiff, 1995.

Deborah Oxley, Convict Maids: The Forced Migration of Women to Australia (Cambridge University Press) Melbourne, 1996.

Elizabeth Grosz and Elspeth Probyn (eds),’ Sexy Bodies: The Strange Carnalities of Feminism (Routledge), London and New York, 1995.     

Reviews

Culture in Africa: An Appeal for Pluralism edited by Raoul Granqvist. Seminar Proceedings No.29. The Scandinavian Institute of African Studies, Uppsala. 1993. 204 pp. illustrated.

Social Change And Economic Reform in Africa edited by Peter Gibbon. Nordiska Afrikainstitutet, Uppsala. 1993. 379 pp. including references and notes on contributors.

The Idea of Africa by V.Y.Mudimbe. Indiana University Press, Bloomington & Indianapolis, and James Currey, London. 1994. xvii plus 234 pp. including illustrations, bibliography and index.

Can National Dialogue Break the Power of Terror in Burundi? Report on the Impact of the International Conference National Dialogue Held in Bujumbura, May 15–18, on Burundian Efforts to Restore Domestic Process in the Country by Zdenek Cervenka and Colin Legum. Current African Issues 17. Nordiska Afrikainstitutet, Uppsala, Sweden. 1994. 29 pp.

Ethnicity in Focus: The South African Case by Simon Bekker. Indicator SA Issue Focus, Centre for Social and Development Studies, University of Natal. 1993. iii plus 117pp. including notes, bibliography and index.

Liquor and Labour in Southern Africa edited by Jonathan Crush and Charles Ambler. Athens and Pietermaritzburg: Ohio University Press and University of Natal Press. 1992. 412 pp. including figures, tables and index.

Chelewa, Chelewa, The Dilemma of Teenage Girls edited by Zubeida Tumbo‐Masabo and Rita Liljestrom. Nordiska Afrikainstitutet. 1994. 218 pp.

Towards More Appropriate Technologies? Experiences from the Water and Sanitation Sector by Mariken Vaa. Report No. 94, Nordiska Afrikainstitutet, Uppsala. 1993. 91 pp. including references.

From the Mountains to the Plains. The Integration of the Lafofa Nuba into Sudanese Society by L.O. Manger. Scandinavian Institute of African Studies, Uppsala. 1994. 175 pp.

The New Local Level Politics in East Africa. Studies on Uganda, Tanzania and Kenya edited by Peter Gibbon. Nordiska Afrikainstitutet, Uppsala. 1994. Research Report No. 95. 118 pp. including figures, notes and references. Paperback. US$9.95.

Tanzania: The Limits to Development from Above by Kjell J. Havnevik. The Scandinavian Institute of African Studies, Uppsala, Sweden. 1993. 343 pp. including tables, bibliography and appendices.

A Blighted Harvest: The World Bank and African Agriculture in the 1980s by Peter Gibbon, Kjell J. Havnevik and Kenneth Hermele. James Currey, London and Africa World Press, Trenton, New Jersey. 1993.     

Interests groups in Parliament: Exploring MPs’ interest affiliations (2000‐2011)

This research note presents an innovative dataset of Swiss MPs’ interest ties between 2000‐2011. The longitudinal analysis shows that the average number of interest ties per MP has more than doubled: from 3.5 in 2000 to 7.6 in 2011. Since the mid‐2000s, public interest groups have accounted for approximately one out of two ties between MPs and interest groups, showing the strongest increase during the period. However, when looking at the most present individual groups, important business groups dominate and appear well connected with the governmental parties of the political right. Finally, interest groups are also able to forge themselves a strategic presence within the parliamentary committees that are the most relevant for their policy issues. Next research steps include the assessment of the (un)biased access of interest groups to the parliamentary venue and their policy influence.     

Book Reviews

Andrea C. Bianculli and Andrea Ribeiro Hoffmann, eds., Regional Organizations and Social Policy in Europe and Latin America: A Space for Social Citizenship? New York: Palgrave Macmillan, 2016. Abbreviations, figures, tables, bibliography, index, 317 pp.; hardcover $109, ebook $84.99. Barry Cannon, The Right in Latin America: Elite Power, Hegemony and the Struggle for the State. New York: Routledge, 2016. Tables, bibliography, index, 182 pp.; hardcover $127.50, paperback $44.59. Jordi Díez, The Politics of Gay Marriage in Latin America: Argentina, Chile, and Mexico. New York: Cambridge University Press, 2015. Bibliography, index, 301 pp.; hardcover $48.99, paperback $29.99, ebook $24. Julio Ríos‐Figueroa, Constitutional Courts as Mediators: Armed Conflict, Civil‐Military Relations, and the Rule of Law in Latin America. Cambridge: Cambridge University Press, 2016. Illustrations, figures, tables, bibliography, index, 256 pp.; hardcover $110, paperback $34.99, ebook $88. María Soledad Segura and Silvio Waisbord, Media Movements: Civil Society and Media Policy Reform in Latin America. London: Zed Books, 2016. Bibliography, index, 224 pp.; hardcover $95, paperback $29.95, ebook $23.96. Lee J. Alston, Marcus André Melo, Bernardo Mueller, and Carlos Pereira, Brazil in Transition: Beliefs, Leadership, and Institutional Change. Princeton: Princeton University Press, 2016. Illustrations, tables, abbreviations, bibliography, index, 280 pp.; hardcover $39.50, ebook. Sean W. Burges, Brazil in the World: The International Relations of a South American Giant. Manchester: Manchester University Press, 2017. Figures, tables, bibliography, index, 296 pp.; hardcover $115, paperback $32.95, ebook. Alejandro Velasco, Barrio Rising: Urban Popular Politics and the Making of Modern Venezuela. Berkeley: University of California Press, 2015. Maps, figures, notes, bibliography, index, 321 pp.; paperback $29.95. Tiffany D. Barnes, Gendering Legislative Behavior: Institutional Constraints and Collaboration. New York: Cambridge University Press, 2016. Map, figures, tables, bibliography, index, 274 pp.; hardcover $99.99, paperback $34.99, ebook $28. Judith Teichman, The Politics of Inclusive Development: Policy, Sate Capacity, and Coalition Building. New York: Palgrave Macmillan, 2016. Figures, bibliography, index, 261 pp.; hardcover $109, ebook $84.99.     

Participatory Governance in Latin America: Promises and Limitations

Maxwell A. Cameron, Eric Hershberg, and Kenneth E. Sharpe, eds., New Institutions for Participatory Democracy in Latin America: Voice and Consequence. New York: Palgrave Macmillan, 2012. Tables, figures, bibliography, index; 263 pp.; hardcover $105, paperback $30, ebook $19.99. Françoise Montambeault, The Politics of Local Participatory Democracy in Latin America: Institutions, Actors, and Interactions. Stanford: Stanford University Press, 2015. Figures, tables, notes, bibliography, index, 288 pp.; hardcover $65, ebook. Patricio Silva and Herwig Cleuren, eds., Widening Democracy: Citizens and Participatory Schemes in Brazil and Chile. Leiden: Brill, 2009. Figures, tables, notes, bibliography, index; 379 pp.; hardcover $87, ebook $90. J. Ricardo Tranjan, Participatory Democracy in Brazil: Socioeconomic and Political Origins. Notre Dame: Notre Dame University Press, 2016. Figures, tables, notes, bibliography; 288 pp.; paperback $35, ebook. Brian Wampler, Activating Democracy in Brazil: Popular Participation, Social Justice, and Interlocking Institutions. Notre Dame: University of Notre Dame Press, 2015. Figures, tables, abbreviations, notes, bibliography, index; 312 pp.; paperback $39, ebook $39.