Influencing Health Policy Change
“The biggest room in the world is the room for improvement.”
- Anonymous
“You never change things by fighting the existing reality.
To change something, build a new model that makes
the existing model obsolete..”
- Buckminster Fuller
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Overview
Traditionally, health policy has been focused mainly on acute care with medicine as the central hub of the health care system. In recent years, in response to the Canada Health Act and other initiatives, a move toward more comprehensive, health and wellness focused policies have begun, at least in theory. “The Committee believes strongly that programs and policies with respect to public health, health protection and health and wellness promotion are critical to enhancing the health of Canadians. We believe that a coordinated and integrated approach is needed and that, once again, the federal government can and should play a leadership role. We believe also that more funding is needed in this area. The Committee recommends that the federal government ensure strong leadership and provide additional funding to sustain, better coordinate and integrate the public health infrastructure in Canada as well as relevant health promotion efforts” (The Standing Senate Committee on Social Affairs, Science and Technology, 2002).
Since health and wellness are the prime foci of nursing, our profession stands in a unique position in influencing policy at both grassroots and political levels. Nurses however are not alone – most allied health professionals feel strongly that health policy must change to encompass primary health care and interdisciplinary collaboration models. “Among the policy and practice communities, it is widely recognized that a strong primary health care (PHC) system is needed to address the challenges of an aging population, and to meet the needs of the increasing proportion of people who experience chronic health conditions. A strong PHC system improves the level and distribution of population health services, buffers the effect of socio-economic factors on health and attains these outcomes at a lower cost than health systems that rely more extensively on secondary and tertiary care. As a result, primary health care renewal has been identified in Canadian policy as a key ingredient in a sustainable health care system,” (EICP, 2005, p. 6).
To understand policies and how they can be changed, a technique/process called policy analysis is used. Policy analysis embraces research, clarification, design, advice, mediation, and democratization as distinct activities and uses pairs of these activities to produce six distinct, though not mutually exclusive styles. These styles include rational, client advice, argumentative, interactive, participative, and process – see Appendix for further details(Mayer, van Daalen & Bots, 2001).
Ends In View
This learning activity is intended to provide learners with the opportunity to:
1. Analyze how health policy relates to the process of health care reform.
2. Identify the components of common policy analysis models.
3. Synthesize nursing's role in health and social policy analysis, revision and development.
4. Recognize the importance of interdisciplinary collaborative in both primary health care reform and influencing health policy development/revision.
In Preparation
1. READ: Alexander, D. (n.d.) Organizing for Urban Sustainability: A summary model of social change.
2. READ: International Council of Nurses. (2003). Guidelines on shaping effective health policy. March.
3. READ: EICP (2005).
Canadian Policy Context: Interdisciplinary Collaboration in Primary Health Care. The Enhancing Interdisciplinary Collaboration in Primary Health Care Initiative. Ottawa: The Conference Board of Canada.
4. READ: The Standing Senate Committee on Social Affairs, Science and Technology. (2002). The health of Canadians – The Federal Role: Final Report. Volume Six: Recommendations for Reform. Chapter 13: Healthy Public Policy: Health beyond health care.
In Practice
1.Participate in class discussion related to health policy development, analysis and reform.
2. The EICP comprehensively rationalizes how and why health policy and reform are best done using interdisciplinary collaboration. In small groups, brainstorm ways that nurses can work with other disciplines in the Fraser Health Region (or other local region of your choice). Share your ideas with the class.
3. How does the current paradigm shift to primary health care favorably situate nursing in relation to having power, sanction, and influence in policy development and reform?
4. The ICN described how nurses can influence health policy through the four components of:
- the policy process
- policy reform
- the policy environment
- policy makers
In small groups, brainstorm how nurses in BC can influence each of these four policy components.
5. Review the policy analysis models and categories presented in Apprendix 1 . Divide into eight small groups and brainstorm a mini case scenerio in which to apply the assigned model (assignment will be done in class).
In Reflection
1 Which particular health and social policies do you personally feel motivated to influence?
2.Which policies do you hear or see mentioned the most frequently in the news media? Who is addressing these policies?
References
Alexander, D. (n.d.) Organizing for Urban Sustainability: A summary model of social change.
EICP (2005). Canadian Policy Context: Interdisciplinary Collaboration in Primary Health Care. The Enhancing Interdisciplinary Collaboration in Primary Health Care Initiative. Ottawa: The Conference Board of Canada.
Guidelines on shaping effective health policy. March.
Lennon, M. & Corbett, T. (2003). eds. Policy into action: Implementation research and welfare reform. Washington, DC: Urban Institute Press.
Policy Analysis for public decisions. Lanham, MD: University Press of America.
Mayer, I., van Daalen, C. & Bots, P. (2001). Perspectives on Policy Analysis: A framework for understanding and design. In Association for Public Policy Analysis and Management. Washington, DC.
Quade, E.S. & Carter, G. M. (1989). Analysis for public decisions. 3rd ed. New York: North Holland.
Patton, C. & Sawicki, D. (1993) Basic Methods of Policy Analysis and Planning. 2nd ed. Englewood Cliffs, NJ: Prentice-Hall.
Stokey, E. & Zeckhauser, R. (1978). A primer of policy analysis. New York: WW Norton.
The Standing Senate Committee on Social Affairs, Science and Technology. (2002). The health of Canadians – The Federal Role: Final Report. Volume Six: Recommendations for Reform. Chapter 13: Healthy Public Policy: Health beyond health care.
Weimer, D.L. and Vining, A.R. 1999. Policy analysis, concepts and practise. 3rd ed. Englewood Cliffs: Prentice-Hall.
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Welcome to NRSG 4111!
Health Policy PPT
Health Policy PDF
POLICY DECISION MODEL
Interests in the Policy Formation Process Diagram
The THCU Roadmap for Policy Development Model
Public Support Strategies
Public Support Profiles
The Policy Process Steps
Developing Health Promotion Policies Workbook
Developing Health Promotion Policies Powerpoint Notes
The Eight Steps to Developing a Health Promotion Policy
A Guide to Public Policy
WEB SITES
Canada@150 Project Phases
Government of Canada Policy Research Initiative
Policy.ca - Clearinghouse for Canadian Public Policy
Centre for Social Justice
Women in Public Policy Initiative
Members of Parliament Contacts
The Policy Process: An Overview
Centre for Healthy Aging
Policy and Environmental Model
Third World bears brunt of global warming impact
Syndemic Prevention Network (CDC)
Healthy Policy (blog)
Being Around and Knowing the Players: Networks of Influence in Health Policy
Fraser Health Authority Said No to Private Approach
MEDIA
The Story of Stuff
Be the Change
Patient's Bill of Rights - BCNU
Beyond McWorld: Challenging Corporate Rule
Conversations on Health
COH in Surrey (video clip)
Eco-Socialism for the 21st Century
Langara Dialogue on sustainability of health care
Citizens for Global Solutions (Flash activism)
DoGooder.TV
Free Range Viral Flash Activism
Changents Alpha
The Corporation
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