The Health Canada Policy Toolkit for Public Involvement in Decision
Making
Level 4 Case Study:
Joint Working Group on the Voluntary Sector
Background
Health Canada and voluntary health organizations have a long history
of collaboration and cooperation. Voluntary organizations contribute
to the health of Canadians through service delivery, public and
professional education, research activities, participation in policy
development and through public involvement.
The Joint Working Group on the Voluntary Sector (JWG) was initiated
by several National Voluntary Health Organizations (NVHO) affected
by the proposed elimination of the National Voluntary Health Organizations'
grants and contributions program. The voluntary organizations banded
together to consider how to respond to the proposed program decision
and met with the former Deputy Minister of Health to discuss the
impact of funding termination. At the request of the Deputy Minister,
a Joint Working Group on the Voluntary Sector was established in
March 1997. The mandate of this joint Health Canada - Voluntary
Sector-led process was to produce a proposed framework to re-establish
Health Canada's working relationship with the national voluntary
sector in light of funding reductions.
Why Seek Public Involvement?
Given the vast number of voluntary organizations working in health
in Canada, it was crucial to Health Canada that the viewpoints
from organizations working on a diversity of health issues be reflected
in the JWG process. The goal was to create an enduring framework
for an improved long-term working relationship and ongoing dialogue
between the department and national voluntary organizations working
in health. Intensive involvement of the voluntary sector was therefore
crucial.
Who Was Involved?
The JWG was co-chaired by a senior Health Canada representative
and a senior official representing national voluntary organizations
working in health. Members for both sides of the JWG were selected
to be inclusive of departmental branches and voluntary organizations.
In recognition of the important leadership role carried out at
the national level, the decision was jointly made to concentrate
work on a national framework, cognizant that this national framework
would also be the basis for guiding work of voluntary organizations
operating at the local and regional levels.
The efforts of the JWG were supported at the bureaucratic level
by the Health Canada Inter-Branch Committee on the Voluntary Sector.
Secretariat support was coordinated by the Policy Development and
Coordination Division, HPPB. The Health Promotion Centre of Excellence
in Toronto, because of its reputation for excellence both within
government and the sector, was engaged as a contractor to conduct
workshops on the Framework for Action document with approximately
160 national voluntary organizations working in health.
Description of the Process
The development of the proposed Framework for Action has been
a groundbreaking activity representing almost two years of collaboration.
The JWG asked the consulting firm PPF to prepare an initial draft
of the Framework, which was presented to the JWG in December 1997.
Interquest Canada worked on a followup document which was then
distributed for comment to more than 160 national voluntary organizations
working in health in May 1998. The following month, these same
groups were invited to participate in a one-day plenary and workshop
session on the Framework, organized by the Health Promotion Centre.
These sessions were scheduled in Ottawa and in Toronto, with approximately
70 of the 160 invited groups attending one of the two venues. Organizations
that were unable to attend the meeting were provided with a questionnaire
for written input. A generous time frame was provided for input
in light of the summer timing of the public involvement activity.
The JWG then met in August 1998 to consider the findings from
the workshops and produce a revised Framework. In mid-October,
a revised Framework based on the findings was again sent for review
and comment to the more than 160 organizations that received the
previous draft. The final draft of the proposed Framework, based
on the second round of input, was finalized by the JWG in December
1998. In January 1999, the Framework was formally submitted to
the Deputy Minister of Health. Copies of the final draft also went
to all of the organizations that participated in the process.
Resources
This public involvement process was not resource intensive - less
than $50,000 was spent to support this initiative over two years.
Resources were allocated to the consultants to hold the workshops,
the writing of the document and travel expenses for the JWG members.
The secretariat support provided by HPPB was responsible for supporting
the work of the departmental co-chair, for organizing meetings
and for coordinating the federal government policy response to
the proposed initiatives under the JWG. Participation in the initiative
involved significant amounts of volunteer time on the part of organizations.
Summary of the Outcomes
This public involvement process marks the first time that national
voluntary organizations working in health have come together to
work with Health Canada in developing a proposed Framework to strengthen
the relationship between the department and the sector. Although
the impetus for the creation of the JWG was funding pressures,
the outcome of the JWG process was the creation of a joint Framework
for Action which outlines recommendations for action on several
fronts, as well as a strengthened and renewed relationship.
The proposed Framework for Action outlines the common goal to
help people in Canada to improve their own health, the health of
others and the health of their communities. Also highlighted are
the shared principles of Health Canada and the voluntary sector: cooperation
to benefit the health of people in Canada, recognition of diversity,
respect, transparency and accountability.
Since the approval of the document, ongoing work has begun on
joint incremental implementation of the recommendations outlined
in the Framework. Discussions between voluntary sector representatives
and the Deputy Minister have been held to determine how to best
implement the recommendations. No formal evaluation of the process
was undertaken.
This initiative has also had an impact on the relationship between
national voluntary organizations working in health. It provided
a forum for these organizations to come together on common issues
and concerns. Furthermore, it has facilitated the building of national
coalitions of voluntary organizations around common issues such
as the creation of the Canadian Institutes on Health Research.
The JWG model has also been examined extensively by other federal
departments. Specifically, the Framework for Action document served
as a base for the Privy Council Office's Engaging the Voluntary
Sector initiative in 1999.
Analysis
The JWG process provides a practical model for engaging stakeholder
groups in long-term public involvement activities. The development
of the Framework for Action promoted a better understanding of
departmental and voluntary sector viewpoints and strengthened the
lines of communications between the two sectors. The proposed Framework
for Action now serves as the basis for future relationships between
Health Canada and one of its most critically important partners
in health promotion and program and service delivery.
Factors for Success
- Strong level of commitment was demonstrated by Health Canada
senior officials, specifically in terms of policy support.
- This initiative was strengthened by the fact that the impetus
originated with the national voluntary organizations working
in health.
- The two-year public involvement process was generous and able
to scope out and discuss pertinent issues.
- The structure of the JWG (co-chairs from Health Canada and
the voluntary organizations working in health) permitted an open
environment for discussion.
- One of the main factors for success was that the voluntary
sector was able to organize itself to achieve consensus among
the various groups.
Barriers to Success
- The process was representative but not inclusive of all the
possible players. Organizations were agreed upon jointly by Health
Canada and the voluntary sector members of the JWG to represent
an appropriate spectrum of views.
- As evaluation was not built into the process, it is difficult
to apply lessons learned for future public involvement efforts.
- Public involvement activities were directed solely at the organization
level, and not the constituency level of voluntary groups.
- There was a lack of local and regional representation at the
JWG level.
- There is no single mechanism accepted across voluntary organizations
working in health as representing the sector as a whole.
- Many of the government representatives changed over time while
the voluntary sector representatives, on the whole, remained
the same.
Policy Implications
The JWG mechanism is an appropriate process to engage the participation
and solicit the views of many diverse interests. The Framework
will have significant and lasting impacts on the policy development
process in that it will serve as a basis for future relationship
building and discussions between the department and the voluntary
sector. This public involvement mechanism has been applied to guide
both other Health Canada and federal governmentwide policy initiatives.
This process also marked the beginning of a renewed relationship
with national voluntary organizations critical to the delivery
of health care in Canada.
Public Involvement Techniques Used
- Advisory Committee
- Multilateral Meetings with Stakeholders
- Workshops
Contact Information
Mary Jane Lipkin
Policy Group Manager, Policy and Major Projects Directorate
Population and Public Health Branch
(613) 946-2067
Mary_Jane_Lipkin@hc-sc.gc.ca
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