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February 23, 2007

A Health Conference on Public Engagement

The UBC Centre for Health Services and Policy Research (CHSPR) conference titled "Voices & Choices Public Engagement in Health Care Policy" was held February 22 at the Westin Bayshore. Two weeks earlier, the UBC School for Health Care Management co-hosted a health conference with the Vancouver Board of Trade. Both conferences were worthwhile; CHSPR's focused on the role of the public while the Board of Trade's focused on comparative systems. CHSPR will soon make a pod cast of its conference available on its website.

The morning of CHSPR's conference saw presenters explore public consultation, now called "public engagement", from the viewpoint of consumer activists, political scientists and specialists in democratic participation. Their presentation could be applied to any area of public policy. All of the presenters recognized that public engagement is not an activity for the masses, but one where a small fraction of the population might influence public policy or might be used to lend legitimacy to a policy decision.

In the afternoon Ida J. Goodreau, President and Chief Executive Officer of Vancouver Coastal Health Authority (VCHA), told the conference that VCHA is the only health authority to have a team of staff working on engaging the community. She cited more than a dozen community engagement activities that have contributed to service delivery in areas ranging from pain strategies to programs for suicide survivors. Many of the details of her presentation are expanded upon on the VCHA website.

Goodreau was joined on the panel by Allison Bond, Assistant Deputy Minister for BC's Conversation on Health. She acknowledged that most people are cynical about the "Conversation" but strongly urged people to participate, saying that she firmly believes that the process is open to ideas from anyone who wants to contribute. When criticism was leveled over the health cost clock that appears on the Conversation's website and the suggestion was made that the clock be removed, she said that she could not do that. Some might interpret that as confirming that what could be a useful exercise in public engagement is being undermined by political interference. My cynicism about the Conversation didn't change as a result of Bond's presentation, although I respect her as a politically neutral and competent public servant; however, I concluded that notwithstanding the worst possible motives of the government, it is essential to make submissions to the Conversation. I reached that conclusion after realizing that failing to do so will open the door for the government to implement its agenda and say that critics had an opportunity to contribute and can only blame themselves if they failed to take advantage of it. Government should engage in true conversation by soliciting further comments following the release of its report on the Conversation, but no one should hold their breath waiting for that to happen.

The final presenter at the conference was Vancouver Sun columnist Vaughn Palmer who had the participants rolling with laughter with his tongue-in-cheek comments. He summarized government activities that have distracted public attention from the Conversation, from the Premier's tour of European health care to the firing of the Chair of VCHA and the subsequent resignation of other directors. Palmer argued that the government's action in stopping the attempt to open a private emergency clinic was evidence that there is limited scope for an expanded role for private sector health care delivery. In his concluding comments, Palmer repeated an argument recently used by Health Minister George Abbott when he said that those who use the news media by leaking stories of failures in the public system might undermine confidence in the public system and encourage private alternatives rather than pressure for more public sector funding. That argument could be right; it deserves more attention and research.


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